Chlorhexidine-based antiseptic solution vs alcohol-based povidone-iodine for central venous catheter care.
Arch Intern Med
; 167(19): 2066-72, 2007 Oct 22.
Article
em En
| MEDLINE
| ID: mdl-17954800
ABSTRACT
BACKGROUND:
Although chlorhexidine-based solutions and alcohol-based povidone-iodine have been shown to be more efficient than aqueous povidone-iodine for skin disinfection at catheter insertion sites, their abilities to reduce catheter-related infection have never been compared.METHODS:
Consecutively scheduled central venous catheters inserted into jugular or subclavian veins were randomly assigned to be disinfected with 5% povidone-iodine in 70% ethanol or with a combination of 0.25% chlorhexidine gluconate, 0.025% benzalkonium chloride, and 4% benzylic alcohol. Solutions were used for skin disinfection before catheter insertion (2 consecutive 30-second applications separated by a period sufficiently long to allow for dryness) and then as single applications during subsequent dressing changes (every 72 hours, or earlier if soiled or wet).RESULTS:
Of 538 catheters randomized, 481 (89.4%) produced evaluable culture results. Compared with povidone-iodine, the chlorhexidine-based solution was associated with a 50% decrease in the incidence of catheter colonization (11.6% vs 22.2% [P = .002]; incidence density, 9.7 vs 18.3 per 1000 catheter-days) and with a trend toward lower rates of catheter-related bloodstream infection (1.7% vs 4.2% [P = .09]; incidence density, 1.4 vs 3.4 per 1000 catheter-days). Independent risk factors for catheter colonization were catheter insertion into the jugular vein (adjusted relative risk, 2.01; 95% confidence interval, 1.24-3.24) and use of povidone-iodine (adjusted relative risk, 1.87; 95% confidence interval, 1.18-2.96).CONCLUSION:
Chlorhexidine-based solutions should be considered as a replacement for povidone-iodine (including alcohol-based) formulations in efforts to prevent catheter-related infection.
Buscar no Google
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Povidona-Iodo
/
Cateterismo Venoso Central
/
Clorexidina
/
Infecção Hospitalar
/
Contaminação de Equipamentos
/
Anti-Infecciosos Locais
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Arch Intern Med
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
França