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Chlorhexidine bathing cuts infections on ICU

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f876 (Published 13 February 2013) Cite this as: BMJ 2013;346:f876

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Bathing patients on intensive care units (ICUs) with cloths impregnated with chlorhexidine helped prevent bloodstream infections in a cluster randomised trial from the US (4.78 v 6.60 cases per 1000 patient days; P=0.007). Eight medical and surgical units and one bone marrow transplant unit used the cloths for six months and control cloths for another six months. Chlorhexidine bathing was associated with significantly fewer bloodstream infections linked to central venous catheters and significantly fewer bloodstream infections with no obvious secondary cause. The chlorhexidine cloths seemed to work best against infections caused by coagulase negative staphylococci.

Participating units enrolled a total of 7727 patients. They were less likely to acquire meticillin resistant Staphylococcus aureus or vancomycin resistant enterococci when chlorhexidine cloths were in use (5.10 v 6.60 cases per 1000 patient days; P=0.03). Staff swabbed all patients on admission and discharge during both crossover periods. Sage products and the US Centers for Disease Control and Prevention funded the trial.

Chlorhexidine cloths were well tolerated, and the authors found no evidence of antimicrobial resistance to chlorhexidine during the study, although they warn that the threat of resistance is real and requires careful monitoring during future studies.

Notes

Cite this as: BMJ 2013;346:f876

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