Decolonisation treatment for people with MRSA

• Your doctor or healthcare provider recently obtained a specimen from you. A bacterium (germ) called MRSA was detected from your specimen.
• Although your infection may have cleared, the MRSA may still be living on your skin or in your nose or throat and your infection may occur again (recurrent infection).
• Decolonisation can reduce the risk of you getting recurrent infections or spreading the MRSA to others, including those who share the same household.
• Decolonisation is also recommended when:
  • you have an increased risk of infection due to other existing medical conditions, such as cancer, diabetes or conditions that weaken your immune system
  • you are planning to have an operation
  • you are a healthcare worker or carer.

Important points about decolonisation treatment

• Any skin infections should be healed before starting decolonisation treatment.
• All household members having decolonisation should start on the same day.
• Report infections that develop during or after the decolonisation treatment to your doctor.
• It is important to stop treatment after 5 days. Treatments should only be repeated following instructions from your doctor or healthcare provider.
• People with skin conditions such as eczema or psoriasis should consult with their doctor.
• Do not use this decolonisation treatment on newborn babies (less than 2 months old).
• Do not use the decolonisation body wash if you have a perforated eardrum. The chlorhexidine ingredient can cause inner ear damage.

Skin care

• If skin irritation or redness occurs, stop using the treatment and discuss with your doctor.
• The skin is an important barrier against infection, and it is essential to prevent dryness or skin tears by following these recommendations:
  • gently pat dry your skin with a towel, avoiding rubbing
  • use a non-perfumed sorbolene-based cream regularly for any itchy or dry areas.

Before starting decolonisation treatment

• Discard your old toothbrush, razor and opened deodorant rollers, and buy new ones.
• Wash your hairbrush and comb with soap and hot water.
• Remove any body piercings for the duration of the treatment.
• Ensure all members of the household have their own towels and wash cloths.
• Maintain household cleaning (wash sheets, towels, laundry and vacuum regularly) before and during decolonisation treatment.

• Perform regular household cleaning and laundry prior to commencement of decolonisation, on day 2 and after completion of treatment on day 5:
  • ovacuum floors and fabric chairs
  • clean surfaces with your normal household cleaning products, paying particular attention to surfaces that are touched frequently, and your bedroom and bathroom
  • wash clothes, bed linen and towels with laundry detergent and (preferably) hot water.
• Recommended MRSA antibiotic nasal ointment and antiseptics:
  • onasal ointment – mupirocin 2% (Bactroban) (available by prescription from your doctor)
  • antiseptic body wash (triclosan 1% or chlorhexidine 2- 4% CHG). Octenisan body wash may be recommended when triclosan or chlorhexidine cannot be used due to allergy. These are available over-the-counter at a pharmacy.

How to use the nasal ointment – apply twice a day for 5 days

1. Wash your hands with soap and water or use an alcohol-based hand sanitiser gel just before using your ointment.
2. Use a new cotton bud to apply a small (double match head) amount of ointment to the inside of each nostril. Dispose of cotton bud after use.
3. Press your nostrils together with thumb and forefinger and massage for about 15 seconds.
4. Don’t get the ointment near your eyes. If any of it gets into your eyes, rinse them well with cool water.
5. Wash your hands with soap and water or use an alcohol-based hand sanitiser gel as soon as you are finished.
6. Do not use any other nasal ointments or nasal sprays during the 5 days.

How to use the body wash – use once a day for 5 days

1. Using a clean wash cloth or your hands, apply the body wash to all body areas, paying attention to areas of hair growth. Make sure to wash under your arms, behind your ears and your knees, your groin area, and between any skin folds. The body wash will not lather very much, and that is okay.
2. When you have finished applying the body wash, leave it on your skin for 2 minutes. Step out of the running water to prevent the body wash being rinsed off to quickly.
3. Shampoo your hair using the body wash on day 1, day 3 and day 5. Your normal conditioner can be used after shampooing.
4. Thoroughly rinse off the body wash. Do not wash with any other soap during the 5 days.
5. Close your eyes and mouth when washing your face or shampooing. If you do get the body wash in your eyes or mouth – rinse with cool water.
6. Dry yourself with a clean towel and put on clean clothes.
7. If you have dentures, remove them before bed and clean them thoroughly. Soak overnight in a denture cleaning product, for example, Steradent or Polident.