Can a bleach bath help treat a staph (Staphylococcus) infection?

Bleach Baths for Staph Infections

Bleach baths can be an effective adjunctive measure for managing recurrent staph infections, particularly in patients with skin conditions, but they are not a primary treatment for active staph infections. 1

Primary Treatment for Staph Infections

The primary treatments for staph infections depend on the type and severity of infection:

• For cutaneous abscesses, incision and drainage is the primary treatment 1
• For simple abscesses or boils, incision and drainage alone is often adequate 1
• Antibiotic therapy is recommended for more severe infections with:
  • Extensive disease or rapid progression with cellulitis 1
  • Signs of systemic illness 1
  • Comorbidities or immunosuppression 1
  • Extremes of age 1
  • Abscesses in difficult-to-drain areas (face, hand, genitalia) 1
  • Lack of response to incision and drainage alone 1

Role of Bleach Baths in Staph Infections

Bleach baths are primarily recommended as part of decolonization strategies for:

• Patients with recurrent staph skin and soft tissue infections (SSTIs) 1
• Cases where ongoing transmission is occurring among household members 1
• Patients who continue to develop infections despite optimizing wound care and hygiene measures 1

How to Prepare and Use a Bleach Bath

When bleach baths are indicated for recurrent staph infections:

• Use as part of a comprehensive decolonization strategy that includes:
  • Nasal decolonization with mupirocin twice daily for 5-10 days 1
  • Topical body decolonization with dilute bleach baths 1
• Prepare by adding 1/4-1/2 cup of household bleach (6%) to a full bathtub of water (approximately 1 teaspoon per gallon of water)
• Soak for 5-15 minutes
• Rinse thoroughly with clean water afterward
• Typically recommended 2-3 times weekly for 2-3 months for recurrent infections 1

Additional Measures for Managing Staph Infections

For patients with recurrent staph infections, the following measures are also recommended:

• Keep draining wounds covered with clean, dry bandages 1
• Maintain good personal hygiene with regular bathing and hand cleaning 1
• Avoid reusing or sharing personal items (razors, linens, towels) that have contacted infected skin 1
• Focus cleaning efforts on high-touch surfaces using commercially available cleaners 1
• Evaluate household contacts for evidence of staph infection 1

Cautions and Limitations

• Bleach baths are not a substitute for appropriate antibiotic therapy for active infections 1
• They should be used at the correct dilution to avoid skin irritation
• Not recommended as primary therapy for active infections requiring systemic antibiotics 1
• May be contraindicated in patients with severe eczema, open wounds, or bleach sensitivity

Antibiotic Options for Staph Infections

For outpatient treatment of staph skin infections when antibiotics are indicated:

• Clindamycin (A-II) 1
• Trimethoprim-sulfamethoxazole (TMP-SMX) (A-II) 1
• Tetracyclines (doxycycline or minocycline) (A-II) 1
• Linezolid (A-II) 1

For children with minor skin infections:

• Mupirocin 2% topical ointment can be used (A-III) 1
• Tetracyclines should not be used in children under 8 years of age (A-II) 1

Remember that proper diagnosis, appropriate antibiotic selection when indicated, and good wound care remain the cornerstones of staph infection management, with bleach baths serving as a supplementary measure primarily for recurrent infections.