Methicillin Resistant Staph aureus (MRSA) De-Colonization Protocol *

1. Treat boils with incision as needed, antibiotics as needed (TMP/SMX or others depending on strain and susceptibility)
2. To de-colonize:
   1. TMP/SMX DS; 1 tablet twice daily not more than 10 days
   2. 
      
      • Rifampin; 300mg, 2 capsules by mouth daily for 5 days or
      • Mupirocin 2% Ointment; place 0.5 grams intranasally twice a day for 5 days.
   3. 2 % Chlorhexidine Solution; shower or bathe, including under nails and on scalp (or may use shampoo + tea tree oil body lotion) daily for 3 days, then 3 times a week for 2 weeks.
   4. Don't shave body hair during de-colonization
   5. Treat partner, family members, and pets if necessary with Chlorhexidine and Mupirocin, as above.
3. Wear clothing only once before washing. Hot water wash (with/without bleach), hot dryer if possible for clothes, sheets, pillow cases. Do not share razors, towels, or clothing.
4. Lysol or I cup bleach + 9 cups water for surfaces; allow to air dry.

* If isolate Is Methicillin Susceptible Staph aureus (MSSA). Dicloxacillin 500 mg by mouth four times daily for 10 days should be the drug of choice for item 2a above (with cephalexin, clindamycin, or TMP/SMX DS for penicillin allergy).