Eradication of Nasal Staphylococcus Aureus Carriage
Decontamination Agents
Chlorhexidine Gluconate (see Chlorhexidine Gluconate, [[Chlorhexidine Gluconate]]): used for body surface decontamination
Mupirocin (Bactroban): used for eradication of nasal Staphylococcus Aureus carriage (see Staphylococcus Aureus, [[Staphylococcus Aureus]])
Clinical Efficacy in the Prevention of Methicillin-Resistant Staphylococcus Aureus (MRSA) Infection in the ICU
DECIDE Trial of Universal vs Targeted Decolonization to Prevent Infections in the ICU (NEJM, 2013) [MEDLINE]
Universal Decolonization (Chlorhexidine) was Superior to Targeted Decolonization of MRSA Carriers (Chrlorhexidine + Nasal Mupirocin) and MRSA Screening and Isolation Strategies in Preventing the Rate of MRSA Isolates and Bloodstream Infection from Any Pathogen: targeted decolonization was intermediate in effectiveness, while screening and isolation did not decrease the rate of any infections
Universal Decolonization Prevented 1 Bloodstream Infection Per Each 54 Patients
Trial of Body Surface Decolonization on Bacteriuria and Candiduria in the ICU (Lancet Infect Dis, 2016) [MEDLINE]
Universal Decolonization (Chlorhexidine) and Short-Course Nasal Mupirocin Significantly Decreased Candiduria and Any Bacteriuria, But Not for Women
Pharmacology
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Metabolism
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Administration
NASAL
Dose Adjustment
Hepatic:
Renal:
Adverse Effects
Other Adverse Effects
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References
DECIDE Trial. Targeted versus universal decolonization to prevent ICU infection. N Engl J Med. 2013;368:2255–2265 [MEDLINE]
Screening inpatients for MRSA—case closed. N Engl J Med. 2013;368:2314–2315 [MEDLINE]
Effect of body surface decolonisation on bacteriuria and candiduria in intensive care units: an analysis of a cluster-randomised trial. Lancet Infect Dis. 2016 Jan;16(1):70-9. doi: 10.1016/S1473-3099(15)00238-8. Epub 2015 Nov 27 [MEDLINE]
