45 Eradication of community-onset MRSA carriage 3 Figure 1. Factors of influence on the decision for eradiation treatment in an individual MRSA carrier. The decision to start eradication therapy in an MRSA carrier should be guided by the treatment goal and the likelihood of long-term success of decolonization treatment, influenced by both the presence of individual risk factors for failure and the prevalence of MRSA in the environment, driving the risk of recolonization. MRSA, methicillin-resistant Staphylococcus aureus. Strategies for eradication therapy MRSA eradication therapy usually exists of either topical - i.e. nasal ointment and skin wash-therapy alone or a combination of topical and systemic anti-staphylococcal agents. Topical therapy is proven to be effective in nasal-only carriage and in temporary (presurgical) load reduction [25,26]. In contrast, in patients with other body sites positive for MRSA, eradication with mupirocin and chlorhexidine skin wash is reported to be insufficient [27-29]. In a randomized controlled trial (RCT) of hospitalized patients colonized with MRSA on multiple body sites in a hospital
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