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  • Chlorhexidine-impregnated dressing for prevention of catheter-related bloodstream infection: a meta-analysis*.

Chlorhexidine-impregnated dressing for prevention of catheter-related bloodstream infection: a meta-analysis*.

Critical care medicine (2014-03-29)
Nasia Safdar, John C O'Horo, Aiman Ghufran, Allison Bearden, Maria Eugenia Didier, Dan Chateau, Dennis G Maki
ABSTRACT

To assess the efficacy of a chlorhexidine-impregnated dressing for prevention of central venous catheter-related colonization and catheter-related bloodstream infection using meta-analysis. Multiple computerized database searches supplemented by manual searches including relevant conference proceedings. Randomized controlled trials evaluating the efficacy of a chlorhexidine-impregnated dressing compared with conventional dressings for prevention of catheter colonization and catheter-related bloodstream infection. Data were extracted on patient and catheter characteristics and outcomes. Nine randomized controlled trials met the inclusion criteria. Use of a chlorhexidine-impregnated dressing resulted in a reduced prevalence of catheter-related bloodstream infection (random effects relative risk, 0.60; 95% CI, 0.41-0.88, p = 0.009). The prevalence of catheter colonization was also markedly reduced in the chlorhexidine-impregnated dressing group (random effects relative risk, 0.52; 95% CI, 0.43-0.64; p < 0.001). There was significant benefit for prevention of catheter colonization and catheter-related bloodstream infection, including arterial catheters used for hemodynamic monitoring. Other than in low birth weight infants, adverse effects were rare and minor. Our analysis shows that a chlorhexidine-impregnated dressing is beneficial in preventing catheter colonization and, more importantly, catheter-related bloodstream infection and warrants routine use in patients at high risk of catheter-related bloodstream infection and central venous catheter or arterial catheter colonization.

MATERIALS
Product Number
Brand
Product Description

Chlorhexidine, European Pharmacopoeia (EP) Reference Standard
Chlorhexidine dihydrochloride, European Pharmacopoeia (EP) Reference Standard
Supelco
Chlorhexidine, Pharmaceutical Secondary Standard; Certified Reference Material
Sigma-Aldrich
Chlorhexidine, ≥99.5%
Sigma-Aldrich
Chlorhexidine dihydrochloride, ≥98%