title: Chlorhexidine compared with povidone-iodine as skin preparation before blood culture. A randomized, controlled trial.
abstract: BACKGROUND
  Chlorhexidine is better than povidone-iodine for care of catheter sites, but it is not known whether chlorhexidine is superior in reducing blood culture contamination.
  
  
  OBJECTIVE
  To determine whether alcoholic chlorhexidine is a more effective skin antiseptic for collection of blood cultures than aqueous povidone-iodine.
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  Three adult intensive care units in a French university hospital.
  
  
  METHODS
  403 adults who had at least one blood culture drawn through a peripheral vein.
  
  
  METHODS
  Patients were randomly assigned to receive skin preparation with an aqueous solution of 10% povidone-iodine or an alcoholic solution of 0.5% chlorhexidine before phlebotomy.
  
  
  METHODS
  Contamination rates of blood cultures.
  
  
  RESULTS
  Of 2041 blood cultures collected in 403 patients, 124 yielded pathogens. Chlorhexidine reduced the incidence of blood culture contamination more than povidone-iodine (14 of 1019 cultures [1.4%] compared with 34 of 1022 cultures [3.3%]; odds ratio, 0.40 [95% CI, 0.21 to 0.75]; P = 0.004).
  
  
  CONCLUSIONS
  Skin preparation with alcoholic chlorhexidine is more efficacious than skin preparation with aqueous povidone-iodine in reducing contamination of blood cultures.
authors.affiliation: Université Paris XI, Hôpital de Bicêtre, Le Kremlin Bicêtre, France.
authors.forename: O
authors.initials: O
authors.lastname: Mimoz
authors.forename: A
authors.initials: A
authors.lastname: Karim
authors.forename: A
authors.initials: A
authors.lastname: Mercat
authors.forename: M
authors.initials: M
authors.lastname: Cosseron
authors.forename: B
authors.initials: B
authors.lastname: Falissard
authors.forename: F
authors.initials: F
authors.lastname: Parker
authors.forename: C
authors.initials: C
authors.lastname: Richard
authors.forename: K
authors.initials: K
authors.lastname: Samii
authors.forename: P
authors.initials: P
authors.lastname: Nordmann
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D001769:Blood / Q000382:microbiology; D001800:Blood Specimen Collection / Q000379:methods* / Q000592:standards*; D002710:Chlorhexidine / Q000008:administration & dosage*; D004202:Disinfectants / Q000008:administration & dosage*; D006801:Humans; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000891:Anti-Infective Agents, Local; D004202:Disinfectants; D011206:Povidone-Iodine; D002710:Chlorhexidine