Abstract
Objective:
The purpose of this pilot trial was to determine whether rates of contact dermatitis following cutaneous antisepsis for central catheter placement were similar among neonates treated with chlorhexidine gluconate and povidone-iodine. Chlorhexidine gluconate absorption was also evaluated.
Study Design:
Infants weighing ⩾1500 g and ⩾7 days of age were randomized to a 10% povidone-iodine or 2% chlorhexidine gluconate site scrub before catheter placement. Primary outcomes evaluated included dermatitis, catheter colonization and chlorhexidine gluconate absorption.
Result:
A total of 48 neonates were enrolled. Colonization rates were similar among treatment groups (P<0.6). Dermatitis did not occur at chlorhexidine gluconate (central catheters, n=24; peripheral catheters, n=29) sites. Seven neonates had measurable chlorhexidine gluconate concentrations (range 13 to 100 ng ml−1) during catheterization.
Conclusion:
In this small trial chlorhexidine gluconate antisepsis was tolerated by study neonates. Chlorhexidine gluconate was cutaneously absorbed. Larger trials are needed to determine efficacy and tolerance of chlorhexidine gluconate in neonates.
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Acknowledgements
We acknowledge the research coordinator assistance received from the various centers—Wheaton Franciscan Healthcare, St Joseph: Elizabeth Bongert, Melinda P Bushong, Leslie L Hofer, Mary Koehnke, Heidi May, Lori A McLain, Dawn M Murphy, Tiffany N Perine, Jackie M Sevallius, Rae Toman, Amy WernerWoida. Aurora Sinai Medical Center: Joan Becker; Children's Hospital of Wisconsin: Laura Lane; Children's Hospital of Philadelphia: Linda Corcoran, Jane Fricko, Sharon Zirin; Children's Hospital (Boston): Hannah Pawlzendo. Financial support was provided by Enturia (formerly Medi-Flex). The sponsor reviewed the study design developed by the primary investigator. It was not involved with the data collection, implementation, analysis or interpretation of data. They had an opportunity to review the paper before publication. The project described was supported by Grant Number UL1-RR-024134 from the National Center for Research Resources. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.
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Garland, J., Alex, C., Uhing, M. et al. Pilot trial to compare tolerance of chlorhexidine gluconate to povidone-iodine antisepsis for central venous catheter placement in neonates. J Perinatol 29, 808–813 (2009). https://doi.org/10.1038/jp.2009.161
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DOI: https://doi.org/10.1038/jp.2009.161
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