Decolonisation of patients colonised with S. aureus
For perioperative decolonisation of patients colonised with S. aureus, use:
mupirocin 2% nasal ointment inside each nostril, twice daily for 5 days surgical prophylaxis, S. aureus decolonisation mupirocin
WITH OR WITHOUT EITHER
for use in showers—an antiseptic wash or soap containing chlorhexidine 2% or 4%; wash once daily for 5 days. Pay particular attention to areas of hairy skin
OR
for use in baths—60 mL of sodium hypochlorite solution (household bleach) per bathtub1; wash once daily for 5 days.
Dilute sodium hypochlorite (household bleach) is preferred for infants and children because it is well tolerated.
Chlorhexidine-impregnated washcloths, applied the night before and morning of surgery, are an alternative to bathing or showering with antiseptics.
The optimal timing of perioperative S. aureus decolonisation is not known. While decolonisation must be started before the procedure, it can be completed after the procedure.
Monitoring for the development of mupirocin resistance is recommended if mupirocin decolonisation is commonly used.