Clearance of nasal Staphylococcus aureus colonization with triple antibiotic ointment

J Drugs Dermatol. 2012 Dec;11(12):1490-2.

Abstract

Background: The prevalence of Staphylococcus aureus colonization of healthcare workers is reported at 30%, with colonization rates for methicillin-resistant S aureus (MRSA) reported between 2.0% and 8.5% among industrialized nations. The anterior nares are the most frequent colonization site. Mupirocin is the standard of care for nasal S aureus decolonization, with decolonization rates as high as 90%. Staphyloccocal resistance to mupirocin has been described, requiring additional management strategies. In certain situations, triple antibiotic ointment (TAO) may be a suitable alternative for elimination of nasal S aureus colonization.

Observations: Adult healthcare workers within an academic-centered hospital (n=216) were screened via nasal swab with culture for S aureus colonization. Forty-!ve subjects (20.8%) screened positive for S aureus; of these subjects, 3 (1.4%) were positive for MRSA. Of the 45 subjects with positive cultures, 30 completed 5 days of twice-daily intranasal TAO application. One week after treatment, all 30 subjects were reswabbed; 16 (53.3%) showed evidence of decolonization on repeat culture.

Conclusions: The rate of S aureus colonization of healthcare workers in our study is lower than published rates in industrialized nations. Intranasal application of TAO may be a viable option for eradication of nasal colonization by methicillin-susceptible S aureus in environments where mupirocin-resistant bacterial strains become more prevalent.

Publication types

  • Clinical Trial

MeSH terms

  • Academic Medical Centers
  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Bacitracin / administration & dosage
  • Bacitracin / therapeutic use
  • Drug Combinations
  • Female
  • Health Personnel
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Nasal Cavity / drug effects
  • Nasal Cavity / microbiology*
  • Neomycin / administration & dosage
  • Neomycin / therapeutic use
  • Ointments
  • Polymyxin B / administration & dosage
  • Polymyxin B / therapeutic use
  • Prospective Studies
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • Ointments
  • Bacitracin
  • Neomycin
  • Polymyxin B