"MRSA" nasal carriers should be treated with?

Appeared in: SCTIMST Staff Nurse - 2016

Explanation

2% Mupirocin is the standard-of-care topical antibiotic for eradicating Methicillin-resistant Staphylococcus aureus (MRSA) from the nasal passages of carriers.
It is applied as an ointment inside the anterior nares, typically twice a day for 5-10 days, to reduce the risk of subsequent infection and transmission.
Its efficacy is specific to eliminating nasal carriage, which is a key component of infection control bundles, especially in high-risk settings like ICUs and pre-operative care.

Option A: This is a broad-spectrum antiseptic, not a targeted antibiotic. It provides only temporary reduction in bacteria and is not the standard for eradication.
Option C: This is not a standard or commercially available strength for intranasal application. The approved and effective concentration is 2%.
Option D: This is a powerful systemic antibiotic reserved for treating active, severe MRSA infections (e.g., sepsis, pneumonia). Using it for colonization increases resistance risk and has potential for toxicity.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological treatment for MRSA nasal decolonization as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in patient education, ensuring they understand the correct technique and importance of completing the full 5-day mupirocin course to successfully decolonize MRSA.
Eradicating nasal carriage is a critical infection prevention strategy to reduce the risk of surgical site infections (SSIs) and prevent transmission to other vulnerable patients.
What if? If a patient is a known MRSA carrier and is scheduled for surgery, the decolonization protocol (nasal mupirocin and chlorhexidine baths) is often started several days before the procedure to minimize infection risk.

How to Approach the Question

First, identify the keywords: 'MRSA' and 'nasal carriers'. This specifies the condition is colonization, not an active systemic infection.
Consider the goal of treatment: to 'eradicate' or 'decolonize' bacteria from a specific site (the nose).
Evaluate the options based on this goal. A topical application is most appropriate for a localized carriage state.
Eliminate Vancomycin, as it is a systemic antibiotic for severe infections.
Compare the topical agents. Mupirocin is a specific antibiotic known for this indication. Povidone-iodine is a general antiseptic, less targeted.
Finally, choose the correct formulation. 2% is the standard strength for intranasal mupirocin, making 10% incorrect.

Concept Tested & Keywords

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E6 Pharmacology Katzung 16e p. 1663-1665

E6 Medicine Harrison 22e Part 1 p. 1193-1195

Practise the full SCTIMST Staff Nurse - 2016

Attempt every question from this paper in a timed mock, then review the full solution for each one.