Friday, August 17, 2012

Chlorhexidine for Infection Prevention- A Systematic Review

Washing with chlorinated lime solution
Here is a systematic review on the topical antiseptic Chlorhexinine, published in the Journal of Hospital Infection. 

Sixteen published studies and four conference abstracts were included int he systematic review. Nine studies reported the impact of CHG on incidence of central-line-associated bloodstream infection (CLABSI); the incidence rate ratio (IRR) was 0.43 [95% confidence interval (CI): 0.26–0.71]. Five studies assessed the impact of CHG washcloths on incidence of surgical site infection (SSI); the RR was 0.29 (95% CI: 0.17–0.49). Four studies reported the impact on vancomycin-resistant enterococci (VRE) colonization; the IRR was 0.43 (95% CI: 0.32–0.59). Three studies reported the impact on meticillin-resistant Staphylococcus aureus (MRSA) colonization rate; the IRR was 0.48 (95% CI: 0.24–0.95). No impact was seen on MRSA, VRE, or acinetobacter infection rates.

By no means is chlorhexidine an in infection control panacea. However, if used regularly as an infection prevention measure for patient surgical/procedure skin preparation, patient bathing and for healthcare worker hand preparation, the impact infection is beneficial. Specifically,  non-rinse CHG application significantly reduces the risk of hospital (central line) associated bloodstream infection, surgical site infections and and colonization with VRE or MRSA.

Chlorhexidine certainly is an advancement over the antiseptic of the 19th century, chlorinated lime solution.


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