Daily bathing with 4% chlorhexidine gluconate in intensive care settings: a randomized controlled trial

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Antimicrobial Stewardship

Background:

• Hospital-acquired infections (HAI) pose a significant threat in intensive care settings.
• Standard bathing practices may not be sufficient to prevent the spread of infections.

Purpose of the Study:

• To evaluate the efficacy of daily bathing with 4% chlorhexidine (CHG) followed by water rinsing (CHGwr) in reducing HAI incidence.
• To assess the safety of the CHGwr intervention in intensive care unit (ICU) patients.

Main Methods:

• A randomized controlled trial was conducted in ICU and post-operative cardiosurgical ICU settings.
• Patients were randomized to receive daily bathing with either 4% CHGwr or standard soap.
• Infectious diseases specialists were blinded to the intervention status.

Main Results:

• The incidence of HAI was significantly lower in the CHGwr group (15%) compared to the standard soap group (25.6%).
• Infection rates per 1000 patient-days were reduced from 40.9 in the control arm to 23.2 in the CHGwr arm.
• A significant reduction in bloodstream infections was observed in the CHGwr group.

Conclusions:

• Daily bathing with 4% CHGwr is an effective strategy for reducing HAI in intensive care settings.
• The intervention demonstrated a significant decrease in overall HAI and bloodstream infections.
• No significant difference in mortality was observed between the intervention and control groups.