Decolonization of MRSA: A Parent's How-To Guide

McKenzie Pediatrics, P.C. 2012

PLAN:

Daily bleach baths (see instructions for bleach bath mixture below) for 7 days, with twice daily application of BactrobanTM (mupirocin, by prescription) to the inside of each nostril.

Then, weekly bleach baths for the next 3 months, and apply mupirocin to the inside of each nostril the first 3 days of each month for 3 months.

It is advised that parents or caregivers who have the closest contact with the affected person also take weekly bleach baths, and apply mupirocin to the inside of the nostrils during the first 3 days of each month for the next 3 months.

Bleach Bath Instructions:

Explain to children that their skin may benefit from “swimming in pool water.” Here is how to make a pool right in their very own bathroom.

1. Add lukewarm water to fill the tub completely (about 40 gallons of water). 2. Depending on the size of the tub/amount of water used, add 1⁄4 to 1⁄2 cup of common bleach

solution to the bath water. Any sodium hypochlorite 6% solution will do. (For example, Chlorox liquid bleach. 3. Stir the mixture to ensure that the bleach is completely diluted in the bath water. 4. Have the child soak in the chlorinated water for 5-10 minutes. 5. Thoroughly rinse skin clear with lukewarm, fresh water at the end of the bleach bath to prevent

dryness and irritation. 6. As soon as the bath is over, pat the child dry. Do not rub dry, as this is the same as scratching. 7. Immediately apply any prescribed medications/emollients. 8. Repeat bleach baths as prescribed by the physician.

The following restrictions apply:

• Do NOT use undiluted bleach DIRECTLY on the skin. Even diluted bleach baths can potentially cause dryness and/or irritation.

• Do NOT use bleach baths if there are many BREAKS or OPEN AREAS in the skin (for fear of intense stinging and burning).

• Do not use bleach baths in children with a known contact allergy to chlorine.