Naseptin vs Bactroban Nasal: Nasal Infection Treatment Options Explained
How the two antibacterial nasal treatments differ, which suits which situation, how to apply them, clearing staph carriage behind recurrent boils, and when a cream is not enough.
Part of the Nasal Infection Guides.
Key fact: Naseptin (chlorhexidine with neomycin) and Bactroban Nasal (mupirocin) both clear Staphylococcus aureus from the front of the nose. Bactroban Nasal works in a shorter course but is kept for limited use to protect it from resistance; Naseptin contains peanut oil and must not be used with a peanut or soya allergy. Neither treats an infection that is spreading across the face, which needs antibiotic tablets.
Get Naseptin or Bactroban Nasal Online
Access Doctor provides Naseptin nasal cream and Bactroban Nasal ointment following a GPhC-regulated online consultation with our pharmacist independent prescribers.
See nasal infection treatments →What nasal antibacterial treatments are for
Antibacterial nasal creams and ointments are applied just inside the nostrils, to the skin of the nasal vestibule, where Staphylococcus aureus bacteria live. They are used in three situations:
| Situation | Aim |
|---|---|
| A mild, localised infection inside the nostril | Treat nasal vestibulitis or folliculitis that is not spreading |
| Recurrent boils or skin infections | Clear staph carriage from the nose, the reservoir that keeps re-infecting the skin |
| Before some operations | Clear MRSA or other staph carriage to reduce wound infection, usually arranged by the hospital |
How a nostril infection is recognised, and what else it can be confused with, is explained in infection inside the nostril.
Naseptin and Bactroban Nasal compared
| Naseptin nasal cream | Bactroban Nasal ointment | |
|---|---|---|
| Active ingredients | Chlorhexidine 0.1% (an antiseptic) and neomycin 0.5% (an antibiotic) | Mupirocin 2% (an antibiotic) |
| Usual course | Four times a day for 10 days to clear carriage | Twice a day for 5 days; no longer than 7 days |
| Key strength | A useful option where mupirocin resistance is present or mupirocin is being kept in reserve | Short course; highly effective at clearing staph carriage, including many MRSA strains |
| Main limitation | Contains peanut (arachis) oil; longer, more frequent course | Resistance develops with repeated or prolonged use, so it is used sparingly |
| Do not use if | Allergic to peanut, soya, chlorhexidine or neomycin | Allergic to mupirocin |
| Age at Access Doctor | 18 and over | 18 and over |
Peanut or soya allergy: do not use Naseptin. Naseptin contains arachis (peanut) oil. Anyone with a peanut allergy, or a soya allergy because of possible cross-reaction, should use an alternative such as Bactroban Nasal.
Which is used when
The choice usually comes down to three things: allergies, whether mupirocin has been used recently, and why the treatment is needed.
Bactroban Nasal is often chosen
For a short, effective course, before an operation when the hospital advises it, or when Naseptin is unsuitable because of a peanut or soya allergy.
Naseptin is often chosen
When a swab shows mupirocin resistance, when mupirocin has been used recently, or to keep mupirocin in reserve.
A swab helps
For repeated infections, a nasal swab shows whether staph is present and which treatment it responds to.
Neither is enough
When redness or swelling is spreading, or you have a fever, antibiotic tablets are needed.
How to apply a nasal cream or ointment
1
Wash your hands and blow your nose gently
Clean hands stop more bacteria being carried in, and a clear nostril lets the treatment reach the skin.
2
Use a small amount
Put an amount about the size of a match head on your little finger or a cotton bud.
3
Apply just inside the nostril
Spread it on the inner surface of the front of the nostril, where the skin and hairs are. There is no need to push it high up the nose.
4
Press the nostrils together
Gently squeeze the sides of the nose for a moment to spread the treatment, then repeat on the other side with a clean cotton bud.
5
Wash your hands again and finish the course
Keep going for the full course even if the soreness settles early, as stopping early leaves bacteria behind.
A tingling or stinging sensation is common for a moment after applying. Stop and seek advice if you get a rash, swelling, or the soreness becomes worse rather than better. Do not share your tube with anyone else.
Recurrent boils and clearing staph carriage
If you keep getting boils, on the face or elsewhere, the source is often Staphylococcus aureus living in your nose and on your skin. Treating each boil without clearing that reservoir means they keep coming back. Clearing it is called decolonisation.
A typical decolonisation course combines a nasal treatment with an antiseptic body wash and some practical steps, all done at the same time:
| Step | What it involves |
|---|---|
| Nasal treatment | Bactroban Nasal for 5 days, or Naseptin for 10 days if mupirocin is unsuitable |
| Antiseptic body wash | An antiseptic skin wash used daily instead of soap, including on the hair, usually for 5 days |
| Laundry | Wash towels, bedding and underwear at a high temperature during the course; use a fresh towel each day |
| Household | If others in the home also get boils, everyone may need to be treated at the same time |
Repeated boils, or boils in several people in one household, should be swabbed. Some staph strains produce a toxin called PVL that causes recurrent, painful boils and occasionally more serious infection. PVL-positive infection is managed with a specific plan from a GP or specialist.
When a nasal cream is not enough
Nasal creams treat infection on the surface of the skin inside the nostril. They are not enough when the infection has gone deeper or wider.
Get same-day medical help if redness or swelling is spreading across the nose or face, the upper lip, cheek or area around the eye is swollen, you have a fever or feel unwell, or you have a severe headache, double vision or eye pain. Spreading infection needs antibiotic tablets, and occasionally hospital treatment.
See a GP or pharmacist if there is no improvement after a week of treatment, the infection keeps returning, there is a large, painful boil that may need draining, or you have diabetes or a weakened immune system.
Which Nasal Treatment Is Right for You?
Our pharmacist independent prescribers check your symptoms, allergies and history of infections, and recommend Naseptin, Bactroban Nasal or a face-to-face review, after a GPhC-regulated online consultation.
See nasal infection treatments →Frequently Asked Questions
What is the difference between Naseptin and Bactroban Nasal?
Naseptin is a cream containing an antiseptic, chlorhexidine, and an antibiotic, neomycin, usually used four times a day for 10 days to clear staph carriage. Bactroban Nasal is an ointment containing the antibiotic mupirocin, usually used twice a day for 5 days. Naseptin contains peanut oil; Bactroban Nasal is kept for limited use to reduce resistance.
Which nasal cream should I use if I have a peanut allergy?
Do not use Naseptin, because it contains arachis (peanut) oil. People with a soya allergy should avoid it too, because of possible cross-reaction. Bactroban Nasal does not contain peanut oil and is the usual alternative, after a check with a pharmacist or prescriber.
How do I apply Bactroban Nasal ointment?
Wash your hands, put a match-head-sized amount on your little finger or a cotton bud, apply it to the inside of the front of one nostril, then press the sides of the nose together to spread it. Repeat on the other side and wash your hands again. It is usually used twice a day for 5 days, and no longer than 7 days.
Why should mupirocin not be used for long?
Staphylococcus bacteria can become resistant to mupirocin if it is used repeatedly or for longer than recommended. Resistance would make it less useful for clearing MRSA before operations and for treating future infections, so courses are kept short and are not repeated without good reason.
Can a nasal cream stop recurrent boils?
It can help, as part of a decolonisation course. Recurrent boils are often caused by staph bacteria living in the nose and on the skin. Using a nasal antibacterial treatment alongside an antiseptic body wash and washing towels and bedding at a high temperature can clear the bacteria and reduce further boils. Repeated boils should also be swabbed.
Do I need antibiotic tablets for a nose infection?
Not usually for a mild infection just inside the nostril, which normally responds to a nasal cream. Antibiotic tablets are needed if redness or swelling spreads across the nose or face, you have a fever, there is swelling around the eye or upper lip, or the infection has not improved with a nasal treatment.
References
- National Institute for Health and Care Excellence. Clinical Knowledge Summary: Boils, carbuncles, and staphylococcal carriage. cks.nice.org.uk
- Joint Formulary Committee. British National Formulary: chlorhexidine with neomycin; mupirocin (nasal). bnf.nice.org.uk
- electronic Medicines Compendium. Summaries of Product Characteristics: Naseptin nasal cream; Bactroban Nasal 2% w/w ointment. medicines.org.uk
- UK Health Security Agency. Panton-Valentine leukocidin (PVL): guidance, data and analysis. gov.uk
- NHS. Boils and carbuncles. nhs.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Naseptin contains peanut oil and must not be used by people with a peanut or soya allergy. Spreading infection of the face needs prompt medical assessment. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.