Many of my patients have never heard of MRSA. But for those of you at risk (see prior blog), have had family members with it, or live in an area where it is common (I found out Santa Cruz has a pretty high rate of MRSA which I did not know), then it is something to look at.
So let’s say you have MRSA. ** NOTE THIS IS NOT MEDICAL 
ADVICE. IF YOU HAVE A MRSA INFECTION YOU MUST GO SEE YOUR DOCTOR. Likely if you are my patient, you had some kind of risk factor, so we had your nose swabbed to check. We found out you are a carrier of MRSA. You want to have elective surgery, so we want to try to decolonize you before surgery. How do we do that?
1. Carefully drain any boils/lesions. Get rid of any supplies carefully, so not to spread it.
2. Shower at home using chlorhexidine (Hibiclens) or hexachlorophene (Phisohex). Do this all over your body.
3. The nose is a common hiding place for MRSA, so you need to clear it from there. Use Mupirocin (Bactroban) 2% ointment to each nostril twice daily for 7 days. **HOUSEHOLD MEMBERS should follow the same protocol. You need to repeat the nasal testing afterwards to see if the treatment worked.
4. Sanitize!! Toilet seats, Door handles, faucets, light switches need to be disinfected. You can spray disinfectants on the upholstery and carpets. Some think Tea Tree oil helps with hardwood floors and bedding (when used in the laundry soap).
5. Handwashing. You should be like Lady Macbeth. Wash wash wash. Place alcohol based sanitizers near bedsides, in your car, etc.
6. Doctors may prescribe an oral antibiotic. This use varies with your symptoms. Common antibiotics used are clindamycin, doxycycline, and Bactrim.
I take precautions with all of my patients to decrease infections, including having them shower for days ahead of their surgery with surgical soap. But even with all of these precautions, MRSA is a risk. It is not a common issue I see in my patients. But I have had about one case a year, and from what I hear from my friends in primary care, the numbers likely will rise.