Volume 8, Issue 3, June 2020, Page: 81-85
The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty
Tristan Symonds, Orthopaedic Research Institute of Queensland, Townsville, Queensland
Hannah Brien, Cairns Private Hospital, Cairns, Queensland
Benjamin Parkinson, Orthopaedic Research Institute of Queensland, Townsville, Queensland; Cairns Private Hospital, Cairns, Queensland
Andrea Grant, Orthopaedic Research Institute of Queensland, Townsville, Queensland
Kenji Doma, Orthopaedic Research Institute of Queensland, Townsville, Queensland
Received: Apr. 7, 2020;       Accepted: Apr. 26, 2020;       Published: May 19, 2020
DOI: 10.11648/j.js.20200803.11      View  209      Downloads  108
Prosthetic joint infections are responsible for a high morbidity and economic cost in patients undergoing total joint arthroplasty. Staphylococcus aureus (S Aureus) is a key modifiable risk factor in the reduction of surgical site infections (SSI). Evidence suggests that decolonization of S aureus carriers reduces the risk of SSI. Octenidine is an antiseptic active against gram-positive and gram-negative bacteria. The aim of this study is to establish the eradication rate of S aureus in patients undergoing total joint arthroplasty using an Octenidine decolonisation protocol prior to surgery. This was a prospective case series performed at the Cairns Private Hospital during a five month trial period of using Octenidine wash and nasal gel in patients undergoing elective TJA. Patients undergoing total joint arthroplasty during a five-month trial period had pre-operative nasal swabs to screen for S aureus pre and post Octenidine treatment. All patients underwent a body wash and nasal gel protocol for five days using Octenidine. The primary outcome was to determine decolonisation rates in patients following the protocol. A total of 183 patients met inclusion criteria into this study. At the first swab 151 (82.5%) patients had normal regional flora and 32 (17.5%) were positive for S aureus. Of these 32 patients 30 (93.75%) were negative for MRSA and 2 (6.25%) had non-multiresistant MRSA. The decolonization rate for patients with S aureus was 76.6%. It was unsuccessful in clearing the two patients with nmMRSA. Octenidine is effective in reducing S aureus colonisation in patients undergoing total joint arthroplasty. Further studies are required to compare this agent to traditional mupirocin based protocols to determine its efficacy as an alternative for use in pre-operative staphylococcal decolonisation.
Total Joint Arthroplasty, Decolonization, Octenidine, Staphylococcus Aureus, Prosthetic Joint Infections
To cite this article
Tristan Symonds, Hannah Brien, Benjamin Parkinson, Andrea Grant, Kenji Doma, The Efficacy of an Octenidine Decolonisation Protocol in Reducing Staphylococcus Aureus Carriage in Patients Undergoing Total Joint Arthroplasty, Journal of Surgery. Vol. 8, No. 3, 2020, pp. 81-85. doi: 10.11648/j.js.20200803.11
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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