Topical antibiotics are a relatively new treatment option that has become popular for post surgical patients with chronic resistant bacteria. A variety of antimicrobials including vancomycin and aminoglycosides that cannot be administered by mouth are available as a nasal spray or wash. Recent studies have suggested that large volume nasal washes do a better job delivering antibiotics into the sinuses than nebulized sprays. These antibiotics can be combined with potent antifungal medications and steroids, each of which will be selected by your physician based on culture results, and custom mixed for you by a compounding pharmacist. Bactroban nasal cream (mupirocin) can be applied inside the nostrils to reduce colonization with methicillin-resistant staph aureus (MRSA).