Summary
Background: Increasing infections and drug resistances lead to new treatment concepts
in terms of MRSA decolonisation. An antibiotic-free decolonisation treatment with
topical antiseptics is of great clinical interest. We investigated the effectiveness
of MRSA decolonisation therapy using the topical antiseptic agent polyhexanide 0.1
%. If needed, a systemic antibiotic was added in case of hospitalisation, abscess
formation, chronic wounds and others.
Patients and methods: 63 patients were introduced to our outpatient clinic within
a period of record of 15 months. 42 (66.7 %) of them were confirmed MRSA-positive
and 27 (64.3 %) of these colonised patients were included to the protocol of decolonisation.
Patients who followed the protocol of decolonisation (n=27) were investigated in terms
of the site of MRSA-colonisation, parameters that minimize the effect of decolonisation,
spa types as well as the effectiveness of the topical antiseptic agent polyhexanide 0.1
%.
Results: 22 patients (81.5 %) were successfully decolonised within the group that
followed the decolonisation protocol (n=27). Using polyhexanide 0.1 % as single treatment
regime seven people (31.8 %) were successfully decolonised, whereas 15 patients (68.2
%) were in need of an additional systemic treatment with antibiotics in order to be
decolonised. The implementation of one topical eradication cycle with polyhexanide
0.1 % was effective in case of an exclusive colonisation of the nose (n=3). At maximum,
three decolonisation runs were necessary. Within six months of post-eradication investigations
no relapses of MRSA were registered.
Conclusions: One third of the decolonised patients were successfully treated with
the topical antiseptic polyhexanide 0.1 %, whereas two thirds of the patients that
followed the decolonisation protocol were in need of an additional systemic antibiotic.
Keywords
Polyhexanide - MRSA - outpatients - mupirocin
