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DEBORAH® Heart and Lung Center MRSA Decolonization Instructions

In the past few years the United States has seen a dramatic increase in the number of people colonized and infected with a bacteria or ‘germ’ resistant to many antibiotics that is called methicillin-resistant Staphylococcus aureus (MRSA). This bacterium has been found in your nose, (nares), and your doctor has prescribed medicine for you that will remove it. The removal of MRSA is called decolonization and it is done to prevent spreading this bacteria to others as well as to protect you during your operative period.

For most patients, decolonization will begin at home or on your first day of your hospital stay.

The directions below describe the most effective approach for successfully removing MRSA from your body and nares.

The treatment for this is very simple and consists of two parts. One part requires that a nasal ointment, called Mupiricin, be rubbed into each of your nostrils twice a day for 5 days.

The other part of the treatment consists of taking a shower or bath using Hibiclens® soap daily for 5 days while you are using the nasal ointment. The nasal ointment will be called into your pharmacy by your doctor and you have received an ample supply of the soap, (Hibiclens). Specific directions for each portion are to the right.

Please contact our Infection Control Department at 609-893-1200 Extension 5303 for any questions.

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Nasal ointment procedure:
1. Use one small tube each time you apply the medicine to your nose (about 1/2 of the small tube to each nostril).

2. Apply a pea-sized amount of mupirocin (Bactroban Nasal®) ointment to the inside of each nostril. Use a clean finger or a Q-tip to apply the medicine.

3. Press your nostrils together and massage for about 1 minute.

4. Avoid contact with your eyes as this could cause irritation.

5. If some medicine gets into your eyes, rinse them thoroughly with cool water.

6. Apply the nasal ointment twice daily for 5 days.

7. Do not use any other topical nasal medications for the 5 days of treatment.

Hibiclens® (4% chlorhexidine) soap shower/bath procedure:
1. Shampoo your hair with regular shampoo first.

2. Shower or bathe with Hibiclens® for each day that you use the nasal ointment application using a freshly laundered wash cloth and towel each time.

3. Use 2 packets for each shower or bath. Each packet contains about 1 tablespoon of the soap.

4. Apply the Hibiclens® as you would any other liquid soap – it will not bubble or lather very much and that is fine. Leave the soap on your skin for 1-2 minutes.

5. Rinse completely after the shower or bath.

6. Avoid contact of the soap with your eyes as this could cause irritation.

7. If some soap gets into your eyes, rinse thoroughly with water.

8. Discard all empty packages in your regular garbage. After each bath or shower put on clean clothes and/or clean pajamas and sleep on freshly laundered sheets.