Take steps to prevent spread of the disease
Early diagnosis of CA-MRSA infection is important to prevent the spread of this highly virulent disease in the community. It’s important to cover the infected area with sterile gauze and instruct the patient to avoid direct skin-to-skin contact with others, not share sports equipment or personal items, and decontaminate linens and surfaces.4,6
Stress the importance of frequent hand washing and using alcohol-based hand rubs to reduce transmission. Adjuvant topical therapy may be useful: intra-nasal mupirocin 2% ointment to prevent colonization and a persistent carrier state is prudent. Bathing with antimicrobial povidone-iodine or chlorhexidine gluconate is often recommended as an adjunctive treatment for skin and soft tissue infections, colonization, or both.14
Mupirocin 2% for our patient
We instructed our patient to continue the initial medications and to apply mupirocin 2% ointment to the nares twice a day for 1 week to eliminate the possibility of a staphylococcal carrier state.
At follow-up 2 weeks later, only a few excoriated papules and some post-inflammatory erythema remained. The topical clindamycin lotion and the doxycycline were continued for an additional 30 days, at which time the patient was clear and treatment was discontinued.