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Evid Based Nurs 5:73 doi:10.1136/ebn.5.3.73
  • Treatment

Chlorhexidine reduced catheter tip colonisation more than 10% povidone-iodine in critically ill neonates


 
 QUESTION: In critically ill neonates, does a chlorhexidine dressing reduce central venous catheter (CVC) tip colonisation and bloodstream infection (BSI) more than 10% povidone-iodine (PI)?

Design

Randomised (allocation concealed), blinded {data analysts}*, controlled trial with follow up to {catheter removal and culture plus 48 hours}*.

Setting

6 level III neonatal intensive care units in 4 university teaching hospitals and 2 community hospitals in the US.

Patients

705 critically ill neonates (mean gestational age 31 wks, 57% boys, 63% white) who would likely require a CVC for ≥48 hours. Because of severe localised contact dermatitis from the chlorhexidine dressing in infants 22.5 to 26.5 weeks gestational age with a catheter inserted ≤8 days after birth, criteria were modified part way through the study to exclude similar infants. Follow up was between 93% and 100%.

Intervention

Neonates were allocated to 1 of 2 groups. In the chlorhexidine group (n=335), …

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