Chlorhexidine disinfectant can reduce the risk of central venous catheter infection compared with povidone: a meta-analysis

Oct. 11, 2019

A study reported in AJIC Journal assessed the efficacy of chlorhexidine with povidone solutions as a skin disinfectant for central venous catheter (CVC) care.

Central venous catheters are widely used for critically ill patients. Catheter maintenance can easily lead to a catheter-related bloodstream infection (CRBSI), which is the manifestation of a bloodstream infection (BSI) in a patient who carries a catheter or removes the catheter within 48 hours. There is no clear source of BSIs except for indwelling catheters in the blood vessels, and BSIs significantly increase the morbidity and mortality of patients. The researchers assessed the efficacy of chlorhexidine with povidone as a skin disinfectant for CVC care.

In July 2018, the researchers from the Department of Emergency Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China, searched the Cochrane Library, PubMed, EMBASE, Web of Science, OVID, CNKI, SinoMed, WanFangData, CqVip, and DuXiu for publications in English and Chinese. By searching articles published before July 2018, they were able to extract data on study design, participants, antiseptics compared, sample size, and main outcomes. They conducted meta-analyses of the efficacy of chlorhexidine vs povidone solutions as a skin disinfectant for CVC care.

Results indicated:

·   In the reduction of catheter-related bloodstream infections, chlorhexidine has been shown to be better than povidone.

·   Any solution of chlorhexidine is associated with a lower rate of catheter colonization than any solution of povidone.

·   The disinfectant effect of chlorhexidine in alcohol solution is better than that of aqueous chlorhexidine, povidone in alcohol solution, or aqueous povidone.

They included 10 randomized controlled trial studies.

Chlorhexidine solution for CVC care may significantly reduce rates of CRBSIs and catheter colonization compared with povidone solutions. The disinfection effect of chlorhexidine-alcohol is better than that of other solutions. Because the quality of the studies evaluated is relatively low, the true effects may be different, so more evidence is needed.

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