Instructions for Home Decolonization of MRSA Prior to Surgery

A guide for patients

Your labs show that you have germs that are resistant to certain antibiotics.  These germs are called Methicillin-Resistant Staphylococcus Aureus (MRSA). The goal of this education is to help with the removal of MRSA.  This process is called “decolonization.” Decolonization before surgery may help decrease the risk of infection in your surgical site.  

There are two parts to the treatment:

Nasal ointment and showering with special soap

  • Applying ointment into each of your nostrils twice a day for 5 days.
  • Taking a shower or bath using a special soap once a day for up to 5 days while you are using the nasal ointment.

You can start this process as soon as you have your prescription.

 

How to use the nasal ointment (mupirocin 2%)

Your ointment requires a prescription. Apply the nasal ointment twice a day for 5 days unless otherwise directed by your doctor.

It will come in several small, single-use tubes or in one larger tube.

Wash your hands or use hand sanitizer before using the ointment.

Small tubes:

  • Twice a day, apply half of the ointment from the tube into one nostril and the other half into the other nostril.
  • Gently squeeze nostrils together and release. Repeat this for about 1 minute to spread the ointment inside nose.
  • Throw away the small tube and use a new one next time.

Large Tube:

  • Twice a day, place a pea sized amount of ointment on a cotton applicator (Q-Tip).  Place ointment inside each nostril.
  • Gently squeeze nostrils together and release. Repeat this for about 1 minute to spread the ointment inside nose.
  • Save the large tube and use it for all your doses.

Don’t get the ointment near your eyes.  If any of it gets into your eyes, rinse them well with cool water.

Wash your hands or use hand sanitizer before using the ointment as soon as you are finished.

Do not use any topical medicines or inside the nose medicines (such as nasal sprays) during the 5 days you are using the ointment.

How to use the soap (4% chlorhexidine) (Hibiclens)

Use 4 ounces of soap each time you shower or bath. 

  1. Shampoo and rinse your hair with your shampoo.
  2. Using a clean washcloth, apply the Hibiclens to all areas of the body.
    • Avoiding your face.
    • Keep out of your eyes, ears, and mouth.  
    • Make sure to wash:
      • armpits
      • behind ears
      • behind knees
      • the groin area
      • between any skin folds.
    • The soap will not bubble or lather very much, and that is fine.
    • If you get the soap in your eyes, ears or mouth – rinse well with cool water.
  1. Leave the soap on your skin for 2 minutes.
  2. Rinse the Hibiclens off your skin
  3. Do not wash with any other soap or cleanser.
  4. Dry off with a clean towel and put on clean clothes.
  5. Using lotion for dry skin is OK, but do not use lotion on the day before or day of your surgery. 

 

If you have any questions about the treatment, please call your provider before you begin.