title: Efficacy of chlorhexidine gluconate use in the prevention of perirectal infections in patients with acute leukemia.
abstract: The frequency of rectal infections is increased in patients with acute leukemia. Complications associated with rectal lesions may be severe enough to cause life-threatening septicemia. Clinical research evaluating the effects of preventive perirectal skin care is scarce. This study's purpose was to determine whether using chlorhexidine gluconate (CHG) in a prophylactic perirectal skin-care regimen decreases perirectal infections and whether it produces more skin irritation than a nonmedicated skin cleanser. The sample consisted of 40 patients, 16 of whom were randomized to use chlorhexidine and 24 of whom were randomized to use nonmedicated skin cleanser. Chi-square and t-tests were used to analyze the incidence of skin breakdown and rectal infections; the correlation between the two factors; a positive history of rectal infections, fissures, or hemorrhoids; presence of hemorrhoids; severity of diarrhea; and duration and severity of granulocytopenia. A positive relationship was found between the severity of granulocytopenia and the incidence of rectal infections (p = 0.02). No significant difference was seen in the occurrence of perirectal infections (p = 0.35) or skin breakdown (p = 0.18) between the two groups. The data suggest that CHG does not offer increased protection against perirectal infections in patients undergoing intensive chemotherapy, nor is it more irritating than a nonmedicated skin cleanser. Further studies are needed to examine the efficacy of hygienic measures such as using skin disinfectants to prevent infections in patients who are immunocompromised.
authors.affiliation: Department of Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston.
authors.forename: A
authors.initials: A
authors.lastname: Yeomans
authors.forename: M
authors.initials: M
authors.lastname: Davitt
authors.forename: C A
authors.initials: CA
authors.lastname: Peters
authors.forename: C
authors.initials: C
authors.lastname: Pastuszek
authors.forename: S
authors.initials: S
authors.lastname: Cobb
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000150:complications; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006920:Hygiene; D007938:Leukemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011349:Proctitis / Q000209:etiology / Q000517:prevention & control*
chemical_list: C010882:chlorhexidine gluconate; D002710:Chlorhexidine