Mupirocin cream versus ointment

Just wanted to find out what other dialysis units are using for MRSA erradication. Apparently the issue came up at York Central Hospital that the Ointment cannot be used on large wounds (MRSA colonized) and upon investigation the CPS monograph mentions the ointment is not indicated for intranasal or in conjenction with cannulae. WELL! That is what WE use it FOR!

The Polyethylene Glycol base of the ointment may be systemically absorbed and has been reported to cause renal failure (esp if used in large open wounds) and/or irritate the nasal mucosa.

On that note, I proposed that the cream may be a safer option, but a letter from GlaxoSmithKline notes that HBP has not approved either the cream or the ointment for Intranasal use (the usual place of application in our population).

Most studies (not sure where performed) use soft paraffin and/or lanolin base. No such product in Canada. In fact, some time between 1995 and 1999 the cream was marketed in Canada. Prior to that, only the ointment was available.

Here comes the question:

What type of MRSA erradication product are you using; is it a cream or an ointment

Has your unit ASKED the question of safety in our population? Have we even thought about the risks of using the OINTMENT or am I just splitting hairs and opening a BIG can of worms?

Our Infection Control RN is looking into other centres she knows to ascertain what the hospitals are doing, and I thought I'd pose the question to the RPN group.

Please respond to me personally and on this posting.

Brenda