• Nathorn Chaiyakunapruk, David L Veenstra, Benjamin A Lipsky, and Sanjay Saint.
• Department of Pharmacy Practice, School of Pharmacy, Naresuan University, Pitsanuloak 65000, Thailand.
• Ann. Intern. Med. 2002 Jun 4;136(11):792-801.

PurposeBloodstream infections related to use of catheters, particularly central-line catheters, are an important cause of patient morbidity, mortality, and increased health care costs. This study evaluated the efficacy of skin disinfection with chlorhexidine gluconate compared with povidone-iodine solution in preventing catheter-related bloodstream infection.Data SourcesMultiple computerized databases (1966 to 2001), reference lists of identified articles, and queries of principal investigators and antiseptic manufacturers.Study SelectionRandomized, controlled trials comparing chlorhexidine gluconate with povidone-iodine solutions for catheter-site care.Data ExtractionUsing a standardized form, two reviewers abstracted data on study design, patient population, intervention, and incidence of catheter-related bloodstream infection from all included studies.Data SynthesisEight studies involving a total of 4143 catheters met the inclusion criteria. All studies were conducted in a hospital setting, and various catheter types were used. The summary risk ratio for catheter-related bloodstream infection was 0.49 (95% CI, 0.28 to 0.88) in patients whose catheter sites were disinfected with chlorhexidine gluconate instead of povidone-iodine. Among patients with a central vascular catheter, chlorhexidine gluconate reduced the risk for catheter-related bloodstream infection by 49% (risk ratio, 0.51 [CI, 0.27 to 0.97]).ConclusionsThese results suggest that incidence of bloodstream infections is significantly reduced in patients with central vascular lines who receive chlorhexidine gluconate versus povidone-iodine for insertion-site skin disinfection. Use of chlorhexidine gluconate is a simple and effective means of reducing vascular catheter-related infections.

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