Efficacy and safety of pure hypochlorous acid solution for neonatal skin bacterial decolonization

The primary aim is to determine the clinical efficacy of pure hypochlorous acid solution (pHA) in preventing neonatal skin Staphylococcus aureus colonization. The secondary aim is to evaluate both the cutaneous and systemic safety and tolerability of full-body application of pHA.

Neonates born at 22-41 weeks' gestation were enrolled during three consecutive cohorts. A full-body wipe with pHA soaked gauze was performed three times a week. The incidence of colonization was then compared 6 months before and after intervention. The neonatal skin condition score, CMP, and LFTs were assessed.

In total, 444 neonates received 1332 applications. There were 32 MRSA-positive colonizations pre-intervention and 15 after, with 53% decrease in the absolute number and a 47% decrease in the rate. There was minimal change in MSSA colonization. There were no signs of systemic or cutaneous toxicity.

Cutaneous application of pHA decreases the incidence of MRSA colonization and demonstrates systemic and topical safety.