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MRSA Colonised Surgical Prophylaxis — SCE Infectious Diseases MCQ

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ModerateInfection Prevention & ControlMRSA Colonised Surgical ProphylaxisSCE Infectious Diseases

A 60-year-old man with known MRSA nasal colonisation undergoes elective total hip replacement. Despite pre-operative decolonisation (nasal Mupirocin plus Chlorhexidine body wash), his post-operative wound swab grows MRSA. What prophylactic antibiotic should have been added at induction?

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Correct answer: A — IV Teicoplanin (or Vancomycin) should have been added to standard prophylaxis at induction in MRSA-colonised patients undergoing prosthetic joint surgery

For MRSA-colonised patients undergoing prosthetic joint surgery, NICE NG125 recommends adding IV Teicoplanin or IV Vancomycin to the standard surgical prophylaxis (Cefuroxime) at induction. This provides MRSA cover in addition to standard surgical flora coverage. Decolonisation and prophylaxis are COMPLEMENTARY, not alternatives.

Reference: NICE NG125 2020 – SSI; UKHSA 2024 – MRSA screening