12.2.3 Nasal staphylococcal infection

For treatment of acute sinusitis refer to ' Antimicrobial Guidelines for Primary Care'.

Nasal staphylococci

Chlorhexidine hydrochloride with neomycin sulphate

(0.1% + 0.5%)

  • Nasal cream (£2.24 = 15g)

Indications

  • Eradication or prevention of nasal carriage of staphylococci

Dose

  • Eradication, apply to nostrils 4 times daily for 10 days
  • Prevention, apply to nostrils twice daily

Notes

  1. Contains peanut oil
Mupirocin

Indications

  • Eradication of nasal carriage of staphylococci, including meticillin-resistant Staphylococcus aureus (MRSA),

Dose

  • Apply 2–3 times daily to the inner surface of each nostril. A sample taken 2 days after treatment to confirm eradication. Course may be repeated once only if the sample is positive

Note

  1. Mupirocin should ideally be kept in reserve to avoid resistance developing. It is particularly useful in a hospital setting to treat MRSA. To avoid the development of resistance, the treatment course should not exceed 7 days and the course not repeated on more than one occasion. Please seek advice from Infection Control or Microbiology.
  2. Where a preferred brand is recommended for a particular presentation, prescribing by brand helps ensure cost-efficient use of local NHS resources (see preferred brand link above)

Other preparations

Cocaine CD
  • 10% nasal spray (unlicensed preparation)

Notes

  1. For use within South Devon and Torbay Foundation NHS Trust
Lidocaine 5% with phenylephrine 0.5%
  • Nasal spray

Epistaxis

Bismuth iodoform paraffin paste (BIPP)
  • Paste
  • Paste impregnated gauze

 

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