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

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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 …

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Footnotes

  • Sources of funding: in part, Johnson and Johnson Medical; Children's Foundation, Children's Hospital, Milwaukee, Wisconsin; National Institute of Health.

  • For correspondence: Dr J S Garland, St Joseph's Hospital, Milwaukee, WI, USA. jsgarland{at}hotmail.com