Commentary on the use of chlorhexidine and alcohol for CLABSI prevention

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International guidelines for the prevention of intravascular CRIs favor using chlorhexidine-alcohol (CHG-OH) solutions for skin preparation before insertion of central venous catheters and peripheral arterial catheters…” Camacho-Ortiz and Román-Mancha (2016).

Extract:

“One of the fundamental interventions that we as clinicians perform on critically ill patients is vascular access. Fluid resuscitation, drug administration, intravascular pressure monitoring, blood gas analysis and hemodialysis are just some of the numerous interventions necessary for survival and better patient outcome. Sadly, there are risks for every well intended intervention and in vascular access the most important one is infection. Millions of patients require these catheters yearly and roughly 5% will develop a catheter-related infection (CRI); up to 35% of those who do, will subsequently succumb to that infection (1,2).

International guidelines for the prevention of intravascular CRIs favor using chlorhexidine-alcohol (CHG-OH) solutions for skin preparation before insertion of central venous catheters and peripheral arterial catheters (3) although they acknowledge the lack of a formal comparison between povidone-iodine plus alcohol (PVI-OH) and CHG-OH; they have left this as an unresolved issue.

A common practice during skin preparation is scrubbing the skin with a detergent before the antiseptic application; although published evidence of its effectiveness is scarce many centers do this as a standard of care.”

Full Text

Reference:

Camacho-Ortiz, A. and Román-Mancha, A.L. (2016) Forget skin scrubbing and other antiseptics: prevent catheter related infections using chlorhexidine plus alcohol. Annals of Translational Medicine. 4(4), p.81.

doi: 10.3978/j.issn.2305-5839.2016.01.04.

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