MRSA decolonisation using polyhexanide 0.1 % with application where necessary of systemic antibiotics

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 polihexanide 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.