TY  - JOUR
T1  - CHlorhexidine-based antiseptic solution vs alcohol-based povidone-iodine for central venous catheter care
AU  - Mimoz O, Villeminey S, Ragot S, et al
Y1  - 2007/10/22
N1  - 10.1001/archinte.167.19.2066
JO  - Archives of Internal Medicine
SP  - 2066
EP  - 2072
VL  - 167
IS  - 19
N2  - 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.Trial Registration 
    clinicaltrials.gov Identifier: NCT00259350
SN  - 0003-9926
M3  - doi: 10.1001/archinte.167.19.2066
UR  - http://dx.doi.org/10.1001/archinte.167.19.2066
ER  -