van Rijen M. Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers. J Evid Based Med. 2009;2:129.

Koburger T, Hübner NO, Braun M, Siebert J, Kramer A. Standardized comparison of antiseptic efficacy of triclosan, PVP-iodine, octenidine dihydrochloride, polyhexanide and chlorhexidine digluconate. J Antimicrob Chemother. 2010;65:1712–9.

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Do not use in combination with cleansing soaps, ointments, oils, enzymes or similar, as this may affect the preservation. In Hospital A, universal daily whole-body chlorhexidine bathing (chlorhexidine gluconate 4%; Microshield∗4, Johnson & Johnson, Australia) has been ongoing since 2014 and continued throughout 2015 and 2016. A 5-day regimen of intranasal octenidine gel (octenidine hydrochloride, Octenisan ® md nasal gel, Schülke & Mayr GmbH, Germany) applied to MRSA-colonisers from the day of admission was instituted from March to July 2016. In Hospital B, universal daily octenidine bathing (octenidine hydrochloride, Octenisan ® wash lotion, Schülke & Mayr GmbH, Germany) with a 5-day regimen of intranasal octenidine (octenidine hydrochloride, Octenisan ® md nasal gel, Schülke & Mayr GmbH, Germany) from the day of admission for MRSA-colonisers was implemented from March to July 2016. Prior to March 2016, Hospital B had not used any antiseptic products for MRSA decolonisation. Neither antiseptic bathing nor intranasal octenidine was administered in Hospital C throughout the study period. Natsuhara KM, Shelton TJ, Meehan JP, Lum ZC. Mortality during total hip periprosthetic joint infection. J Arthroplasty. 2019;34:S337–42.

Van Rijen M, Bonten M, Wenzel R, Kluytmans J. Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers. Cochrane Database Syst Rev. 2008;2:129. Over time the proportion of patients re-swabbed on admission increased, as such there is a statistically significant difference in the proportion between the groups. This is a potential source of bias. The research team discussed this with the nursing staff responsible for admitting patients, it appears the decision was down to the member of staff’s interpretation of the protocol and not any patient factors. Neomycin is an aminoglycoside antibiotic active against both gram-positive and gram-negative bacteria. There is limited research into the efficacy of neomycin ointment for nasal MSSA decolonisation. Leigh et al. showed neomycin achieved nasal decolonisation in 61% of cases compared to 95% with mupirocin at 8days after treatment [ 18]. Resistance to neomycin has been reported as high as 42% in a study from Brazil, the authors note this is likely due to its popular use without prescription in the country [ 19]. octenisan® md nasal gel must not be used with known or suspected allergy to one of the ingredients (propylene glycol, hydroxyethyl cellulose, octenidine HCl). Consult with your physician, if you have any doubts.

For moistening and decontamination of nasal vestibules and supportive wound treatment of lesions in the nasal epithelium Do not use in combination with PVP iodine, as this can lead to discoloration and impaired antiseptic effect of the PVP iodine.

Sousa RJG, Barreira PMB, Leite PTS, Santos ACM, Ramos MHSS, Oliveira AF. Preoperative Staphylococcus aureus screening/decolonization protocol before total joint arthroplasty-results of a small prospective randomized trial. J Arthroplasty. 2016;31:234–9. Perl TM, Cullen JJ, Wenzel RP, Zimmerman MB, Pfaller MA, Sheppard D, et al. Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. N Engl J Med. 2002;346:1871–7. Poovelikunnel T, Gethin G, Humphreys H. Mupirocin resistance: Clinical implications and potential alternatives for the eradication of mrsa. J Antimicrob Chemother. 2015;70:2681–92. Bessa GR, Machado DC, Weber MB, D’Azevedo PA, Quinto VP, Lipnharski C, et al. Staphylococcus aureus resistance to topical antimicrobials in atopic dermatitis. An Bras Dermatol. 2016;91:604–9. Naspetin should also not be applied to patients who also have an allergy to soya, chlorhexidine or neomycin.Octenidine (Octenisan®) nasal gel is applied twice daily for 5 days or until screening results are confirmed, whichever is sooner Neomycin is an aminoglycoside antibiotic active against both gram-positive and gram-negative bacteria. There is limited research into the efficacy of neomycin ointment for nasal MSSA decolonisation. Leigh et al. showed neomycin achieved nasal decolonisation in 61% of cases compared to 95% with mupirocin at 8 days after treatment [ 18]. Resistance to neomycin has been reported as high as 42% in a study from Brazil, the authors note this is likely due to its popular use without prescription in the country [ 19]. For all of the related safety information please refer to the Safety Data Sheet. To view the Safety Data Sheet please visit www.schuelke.com Pérez-Fontán M, Rosales M, Rodríguez-Carmona A, Moncalián J, Fernández-Rivera C, Cao M, et al. Treatment of Staphylococcus aureus nasal carriers in CAPD with mupirocin. Adv Perit Dial. 1992;8:242–5.