How should I treat staphylococcal carriage (boils, carbuncles, folliculitis, paronychia and staphylococcal whitlow)?
• Eliminate nasal carriage: apply mupirocin nasal ointment three times a day for 5 days. • Following treatment, three clear swabs over a 3-week period are required to confirm eradication. • If mupirocin is not effective (e.g. in mupirocin-resistant isolates), consider applying Naseptin® cream (chlorhexidine plus neomycin) four times a day for 10 days. • If both mupirocin and Naseptin® are ineffective, seek expert advice regarding the need for throat-carriage screening and the need for systemic antibiotics. • Eliminate non-nasal carriage: oral treatment with antibiotics may be necessary, especially if there is throat carriage. The choice of antibiotic should be guided by sensitivities. Advice may be sought from the local infection control team. • In addition, advise to: • Use an antiseptic preparation to reduce staphylococcal skin colonization. Washing the skin (preferably including hair), and daily bathing is recommended in an antiseptic solution of chlorhexidine or triclosan in a dete
