Journal of drugs in dermatology : JDD 2012-12-01

Clearance of nasal Staphylococcus aureus colonization with triple antibiotic ointment.

Elizabeth M Grossman, Shivani Nanda, Jennifer R S Gordon, Meghan Dubina, Alfred W Rademaker, Dennis P West, Peter A Lio

Index: Journal. of. Drugs in. Dermatology. 11(12) , 1490-2, (2012)

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Abstract

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.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.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.