{"id":312,"date":"2014-04-02T19:50:08","date_gmt":"2014-04-02T19:50:08","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=312"},"modified":"2017-08-21T12:55:14","modified_gmt":"2017-08-21T12:55:14","slug":"primary-care-corner-with-geoffrey-modest-md-bleach-baths-to-decrease-recurrent-skin-infections","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2014\/04\/02\/primary-care-corner-with-geoffrey-modest-md-bleach-baths-to-decrease-recurrent-skin-infections\/","title":{"rendered":"Primary Care Corner with Geoffrey Modest MD: Bleach baths to decrease recurrent skin infections"},"content":{"rendered":"<p>1000 healthy kids aged 3 months to 18 yrs with probable community-associated staph aureus skin\/soft tissue (SSTI) or invasive infection randomized to daily hygiene vs that with 2x\/week bleach baths for 3 months\u00a0(see\u00a0<strong>DOI: 10.1093\/cid\/cit764<\/strong>). basically,<\/p>\n<p style=\"padding-left: 30px\">&#8211;recurrence of SSTI common: about 50%<br \/>\n&#8211;bleach bath consisted of adding 5ml of bleach (regular bleach, 6.0% hypochlorite) to every gallon of bath water, and bathing in that for 15 min 2x\/week, for 3 months. 12-month followup. dilute bleach solutions known to kill staph.<br \/>\n&#8211;colonization cultures were obtained from nares, pharynx, groin. 56% were colonized with s. aureus at minimum of 1 site (most common = groin in 38%, nares 22%, throat 17%). MRSA (methicillin-resistant) more common in groin and throat, MSSA (methicillin-sensitive) in nose. more colonization in younger ages, esp &lt;2yo<br \/>\n&#8211;rate of &#8220;medically-attended&#8221; recurrent infection: 17% with bleach bath and 20.9% with regular hygiene (not significant, but arguably too small a trial: needed around 1000 kids to detect 50% reduction with 90% power). no diff between MRSA and MSSA infections (though most infections were MRSA). higher rates of infection with more colonization sites culture-positive<br \/>\n&#8211;not adverse effects found, other than dry skin in a few kids and burning eyes in 1 patient only.<\/p>\n<p>\u00a0so, obviously a small study at least in terms of outcomes, only with kids, short-term (3 months of baths, with 12 month follow-up) and not powered to get significant results. but, besides that, pretty intriguing&#8230; recurrent staph infections really common in kids and adults. seems like a pretty benign therapy (esp given the alternatives of recurrent courses of antibiotics, need for frequent ER visits, etc &#8212; ie alternatives not great). and by my quick and dirty (?) measurements in my bathtub, 6&#8243;deep water would require 4 ounces of bleach. so, might be reasonable to try in people with documented recurrent infections???? i checked out the Am Acad of Dermatology website for hidradenitis, and they suggested bleach bath as one approach (1\/2 cup non-scented bleach to 1\/2 full bathtub of water), noting that it works sometimes.<\/p>\n<p>geoff<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bleach baths to decrease recurrent skin infections [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2014\/04\/02\/primary-care-corner-with-geoffrey-modest-md-bleach-baths-to-decrease-recurrent-skin-infections\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":148,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[14283],"tags":[],"class_list":["post-312","post","type-post","status-publish","format-standard","hentry","category-archive"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/312","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/users\/148"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/comments?post=312"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/312\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/media?parent=312"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/categories?post=312"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/tags?post=312"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}