title: Comparison of 10% povidone-iodine and 0.5% chlorhexidine gluconate for the prevention of peripheral intravenous catheter colonization in neonates: a prospective trial.
abstract: The purpose of the study was to compare the efficacy of 10% povidone-iodine with that of 0.5% chlorhexidine gluconate in 70% isopropyl alcohol for the prevention of peripheral intravenous catheter colonization in neonates. This was a multicenter, nonrandomized prospective study in a tertiary neonatal intensive care setting in which povidone-iodine and chlorhexidine gluconate were each used as antiseptic skin preparations over sequential 6-month periods. During the first 6 months of the study when povidone-iodine was in use 9.3% (38 of 408) of catheters were colonized. During the second 6 months of the study when chlorhexidine gluconate was in use, catheter colonization occurred in 4.7% (20 of 418, P = 0.01). Catheter-related bacteremia occurred during only 0.2% (2 of 826) of all catheterizations. Heavy skin colonization before catheter insertion (relative risk, 3.6; 95% confidence interval, 1.9, 7.0), catheterization > or = 72 hours (relative risk. 2.0; 95% confidence interval, 1.01, 3.8) and gestational age < or = 32 weeks (relative risk, 1.8; 95% confidence interval, 1.02, 3.3) increased colonization risk. Ampicillin infusion (relative risk, 0.4; 95% confidence interval, 0.2, 0.7) and 0.5% chlorhexidine gluconate cutaneous antisepsis (relative risk, 0.4; 95% confidence interval, 0.2, 0.8) were factors associated with decreased colonization risk. We conclude that 0.5% chlorhexidine gluconate in 70% isopropyl alcohol appears to be more efficacious than 10% povidone-iodine for the prevention of peripheral intravenous catheter colonization in neonates.
authors.affiliation: Joint Program in Neonatology, Harvard Medical School, Boston, MA, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Garland
authors.forename: R K
authors.initials: RK
authors.lastname: Buck
authors.forename: P
authors.initials: P
authors.lastname: Maloney
authors.forename: D M
authors.initials: DM
authors.lastname: Durkin
authors.forename: S
authors.initials: S
authors.lastname: Toth-Lloyd
authors.forename: M
authors.initials: M
authors.lastname: Duffy
authors.forename: P
authors.initials: P
authors.lastname: Szocik
authors.forename: T L
authors.initials: TL
authors.lastname: McAuliffe
authors.forename: D
authors.initials: D
authors.lastname: Goldmann
mesh_terms: D000704:Analysis of Variance; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D000985:Antisepsis; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D001419:Bacteria / Q000254:growth & development; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002710:Chlorhexidine / Q000008:administration & dosage*; D015169:Colony Count, Microbial; D004866:Equipment Contamination / Q000517:prevention & control; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; D002710:Chlorhexidine