Given the rising incidence of MRSA infection in Germany, the Robert Koch Institute (RKI) emphatically supports the consistent implementation of prevention strategies. According to statements by the RKI, the detection of MRSA in Staphylococcus aureus isolates has increased since the 1990s, from 8% in 1995 to over 20% in 2001. This percentage has already risen to around 30% in intensive care units. Strict hygiene precautions can successfully limit the spread of pathogens. Antibacterial agents should be used for disinfection, particularly in the case of patient colonisation with MRSA. Local antibiotics are another established form of treatment. However, the growing development of resistance makes their use seem questionable, when the goal of decontamination and freedom from MRSA can no longer be achieved by conventional means.
Successful decontamination in MRSA colonisation
The local antibiotic Mupirocin nasal ointment is an established means of eradicating nasal colonisation. It should, however, be noted that there are known cases of resistance to this antibiotic, and that the unilateral use of one single local antibiotic exerts even more selection pressure on the microorganisms.
One alternative is the use of non-specific antimicrobial substances. The main thing to consider with selecting these – apart from their efficacy – is whether they are well tolerated by the skin and mucous membranes. The substance polyhexanide is an almost ideal combination of efficacy and tolerance. Finding the optimum pharmaceutical form also plays a crucial role in the development of a user-friendly product from a raw substance.
B. Braun Melsungen AG recently introduced an holistic solution for the successful decontamination of MRSA carriers, namely its polyhexanide-based Prontoderm system. Unlike practice to date, this system offers something for all regions of the body that may be colonised with MRSA, and decontaminates them with products tailored specially to the particular target site. Apart from their efficacy and user-friendliness, the highlight of these products is that they are well tolerated by the skin and mucous membranes.
The Prontoderm system consists of several complementary components. The main product is the Prontoderm solution – a ready-to-use solution for full-body, antiseptic cleaning, patient care and fighting odour. There is also a gel for the antimicrobial decontamination of the nasal vestibules. Prontoderm Foam can be used to treat in particular the hair and scalp; the foam is also used to care for bedridden patients. The specially developed mouthwash, ProntOral, is used for MRSA decontamination in the mouth and throat area.
This system enables effective and complete MRSA decontamination of the patient.
Another problem – especially in MRSA patients – is the particularly complex care of chronic wounds. MRSA in wounds can defeat any successful decontamination. The difficulty here is that if wounds are infected, bacteria can multiply under the dressings, which impairs wound healing on the one hand, and leads to perpetual recolonisation of the patient on the other.
B. Braun's Prontosan is an innovative wound irrigation solution for infected wounds. Compared to conventional rinsing solutions, Prontosan wound irrigation solution stands out because of its special surface and decontamination activity – the result of an exceptional, well tolerated, amphoteric detergent. The decontamination activity, which has been confirmed in expert reports, thus fulfils the requirement for successful wound management.
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