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Ann Intern Med. 2002 Jun 4;136(11):792-801.

Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: a meta-analysis.

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1
Department of Pharmacy Practice, School of Pharmacy, Naresuan University, Pitsanuloak 65000, Thailand.

Abstract

PURPOSE:

Bloodstream infections related to use of catheters, particularly central-line catheters, are an important cause of patient morbidity, mortality, and increased health care costs. This study evaluated the efficacy of skin disinfection with chlorhexidine gluconate compared with povidone-iodine solution in preventing catheter-related bloodstream infection.

DATA SOURCES:

Multiple computerized databases (1966 to 2001), reference lists of identified articles, and queries of principal investigators and antiseptic manufacturers.

STUDY SELECTION:

Randomized, controlled trials comparing chlorhexidine gluconate with povidone-iodine solutions for catheter-site care.

DATA EXTRACTION:

Using a standardized form, two reviewers abstracted data on study design, patient population, intervention, and incidence of catheter-related bloodstream infection from all included studies.

DATA SYNTHESIS:

Eight studies involving a total of 4143 catheters met the inclusion criteria. All studies were conducted in a hospital setting, and various catheter types were used. The summary risk ratio for catheter-related bloodstream infection was 0.49 (95% CI, 0.28 to 0.88) in patients whose catheter sites were disinfected with chlorhexidine gluconate instead of povidone-iodine. Among patients with a central vascular catheter, chlorhexidine gluconate reduced the risk for catheter-related bloodstream infection by 49% (risk ratio, 0.51 [CI, 0.27 to 0.97]).

CONCLUSIONS:

These results suggest that incidence of bloodstream infections is significantly reduced in patients with central vascular lines who receive chlorhexidine gluconate versus povidone-iodine for insertion-site skin disinfection. Use of chlorhexidine gluconate is a simple and effective means of reducing vascular catheter-related infections.

PMID:
12044127
[Indexed for MEDLINE]
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