What is an effective antibacterial body wash for Staphylococcus (Staph) colonization of the skin?

From the Guidelines

For staph colonization of the skin, I recommend using chlorhexidine gluconate (CHG) 4% bodywash, such as Hibiclens, as the first-line antibacterial bodywash, as suggested by the Infectious Diseases Society of America guidelines 1.

Key Considerations

• Use the bodywash daily for 5-7 days initially, then 2-3 times weekly for maintenance if needed, as part of a decolonization strategy that may include nasal decolonization with mupirocin twice daily for 5–10 days 1.
• Apply the wash to wet skin, lather gently for 1-2 minutes focusing on areas prone to colonization (armpits, groin, skin folds), then rinse thoroughly, while maintaining good personal hygiene with regular bathing and cleaning of hands with soap and water or an alcohol-based hand gel 1.
• Avoid using it on the face, genitals, or open wounds, and consider alternative options such as benzoyl peroxide 4-5% wash or diluted bleach baths (1/4-1/2 cup regular bleach in a full bathtub of water, soaking for 5-10 minutes) for effective decolonization 1.

Additional Measures

• For severe or recurrent colonization, combine the bodywash with intranasal mupirocin ointment, as the nose is often a reservoir for staph, and consider evaluating and treating symptomatic contacts, as well as nasal and topical body decolonization of asymptomatic household contacts 1.
• If symptoms persist or worsen despite these measures, consult a healthcare provider as oral antibiotics may be necessary, and maintain good personal hygiene practices, such as keeping draining wounds covered with clean, dry bandages, and avoiding reusing or sharing personal items that have contacted infected skin 1.

From the FDA Drug Label

Uses surgical hand scrub: significantly reduces the number of microorganisms on the hands and forearms prior to surgery or patient care healthcare personnel handwash: helps reduce bacteria that potentially can cause disease patient preoperative skin preparation: for the preparation of the patient's skin prior to surgery skin wound and general skin cleansing For washing to decrease bacteria on the skin.

Antibacterial bodywash options for staph colonization of skin include:

• Chlorhexidine gluconate 2: can be used for skin wound and general skin cleansing, which may help reduce staph colonization.
• Triclosan 3: can be used for washing to decrease bacteria on the skin, which may help reduce staph colonization.

From the Research

Antibacterial Bodywash for Staph Colonization of Skin

• The use of antibacterial bodywash has been studied as a method for reducing Staphylococcus aureus colonization on the skin 4, 5, 6, 7.
• Chlorhexidine has been shown to be effective in reducing MRSA colonization, particularly in the groin area 4.
• A study found that whole-body washing with 4% chlorhexidine solution reduced skin colonization, but complete eradication required additional measures such as treatment of the gastrointestinal tract, wounds, and other colonized body sites 4.
• Another study found that a standardized regimen including chlorhexidine soap, mupirocin nasal ointment, and oral vancomycin was highly effective in decolonizing MRSA carriers 6.
• Chlorhexidine whole-body washing has also been shown to reduce hospital-acquired S. aureus infections and have a direct effect on the distribution of the ST5-MRSA-II clone 7.
• Povidone iodine has been proposed as an alternative decolonization agent, with studies showing its rapid and superior bactericidal activity against MRSA, including chlorhexidine-resistant and mupirocin-resistant strains 8.

Effective Agents for Decolonization

• Chlorhexidine gluconate (CHG) has the strongest evidence base for skin decolonization and is associated with prevention of infections due to Gram-positive and Gram-negative organisms as well as Candida 5.
• Mupirocin is still the gold standard agent for S. aureus nasal decolonization, but there is concern about mupirocin resistance, and alternative agents such as povidone iodine are being considered 5, 8.
• Sodium hypochlorite can also be recommended for skin decolonization, while triclosan use is discouraged due to inferior outcomes and increased risk of allergic dermatitis 5.

Considerations for Decolonization

• The most effective decolonization strategy may involve a combination of agents and treatments, including nasal topical decolonization, topical skin decolonization, oral decolonization, and selective digestive or oropharyngeal decontamination 5.
• The choice of decolonization agent and treatment regimen should be based on individual patient factors, such as the location and extent of colonization, and the presence of any underlying medical conditions 6.
• Further research is needed to evaluate the effectiveness of different decolonization strategies and to develop new agents and treatments for reducing Staphylococcus aureus colonization and infection 5, 8.