Clearance of nasal Staphylococcus aureus colonization with triple antibiotic ointment

• Published in: Journal of drugs in dermatology Vol. 11; no. 12; p. 1490
• Main Authors: Grossman, Elizabeth M, Nanda, Shivani, Gordon, Jennifer R S, Dubina, Meghan, Rademaker, Alfred W, West, Dennis P, Lio, Peter A
• Format: Journal Article
• Language: English
• Published: United States 01.12.2012
• Subjects: 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
• ISSN: 1545-9616

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.