Tackling the anterior nares and other sites of colonization: implications for the dermatologist.

Persistent Staphylococcus aureus nasal carriage has been identified in patients with S aureus infections, but the effectiveness of decolonization in decreasing the risk of infection has been met with variable success, partly due to the inconsistent efficacy of topical agents such as mupirocin and chlorhexidine gluconate in clearing S aureus carriage. Furthermore, although decolonization would seem to be a logical means to reduce the incidence of infection, the data supporting eradication of S aureus nasal colonization as a prophylactic are equivocal. Resistance to topical antibacterial agents has been reported. These factors, combined with the potential correlation of nasal colonization to clinical infection, warrant the careful use of topical and systemic antibacterial agents to reduce the chance of resistance, thereby maximizing their usefulness in treating infection.