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Efficacy of Adding 2% (w/v) Chlorhexidine Gluconate to 70% (v/v) Isopropyl Alcohol for Skin Disinfection Prior to Peripheral Venous Cannulation •

Department of Clinical Microbiology and Infection Control, University Hospital Birmingham NHS Foundation Trust, The Queen Elizabeth Hospital, Edgbaston, England.
Infection Control and Hospital Epidemiology (Impact Factor: 4.18). 10/2008; 29(10):963-5. DOI: 10.1086/590664
Source: PubMed

ABSTRACT

We undertook a clinical trial to compare the efficacy of 2% (w/v) chlorhexidine gluconate in 70% (v/v) isopropyl alcohol with the efficacy of 70% (v/v) isopropyl alcohol alone for skin disinfection to prevent peripheral venous catheter colonization and contamination. We found that the addition of 2% chlorhexidine gluconate reduced the number of peripheral venous catheters that were colonized or contaminated.

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Available from: Cynthia Crosby, May 29, 2015
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    • "In view of the low frequency of infections, a direct, randomized comparison would require a very numerous sample. For catheter infections, an acceptable surrogate result could be obtained by ascertaining contamination of the catheter tips [8] [10] [13] [20] [21] . "

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    • "Thus, our results in this study indicate a lower contamination rate than that previously reported for both of these antiseptics. In the same study, Small et al. (2008) found that, in the subgroup of patients who had received antibiotic therapy, the colonization rate increased to 66.7% in the PVCs inserted after antisepsis with povidone and 37.5% after antisepsis with chlorhexidine. In this study, the contamination rate in the subgroup of patients who had received antibiotic therapy was 8.7% (2 of 23). "
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    ABSTRACT: Although it can be prevented, catheter-related bacteremia is common and dangerous. The antiseptics most widely used during insertion of peripheral venous catheters (PVCs) include povidone iodine, alcohol, and chlorhexidine. Another widely used antiseptic is a solution of 0.057 g sodium hypochlorite. This pilot study explored the contamination rate of the PVC tip inserted after skin decontamination with sodium hypochlorite. Culture analysis of the tips of the PVCs inserted into the 42 participants showed 7 (16.7%) colonized catheters. The results of this pilot study suggest taking into serious consideration the assessment of this antiseptic in randomized experimental studies.
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    • "In this study, 23.4% (45/192) of positive responses were seen after disinfection with 70% isopropyl alcohol. This result is similar to previous studies' results of 12-49% [13,14]. Therefore, when alcohol is used as a single agent for disinfection, a reasonable amount of bacteria should be presumed to remain active. "
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    ABSTRACT: Many disinfectants have been used clinically in both single and combination applications, but there have been few studies on disinfective power according to sterilization sequence when using a combination of disinfectants. The purpose of this study was to evaluate the disinfective power of a combination of 70% isopropyl alcohol and 10% povidone-iodine (PVP-I) according to sterilization sequence. Two hundred healthy volunteers were recruited. Subjects were disinfected with a combination of 70% isopropyl alcohol and 10% PVP-I on both forearms, in varying sequence. The AP group included disinfections on the left forearm with isopropyl alcohol first followed by 10% PVP-I, while the PA group included disinfections on the right forearm with same disinfectants in reverse order. Skin cultures were obtained using cotton swabs 3 min after application of each disinfectant, and then were inoculated on blood agar plates for bacterial culture. Cultures were incubated at 37℃ under aerobic conditions for 48 hours. There was no significant difference in the number of positive cultures after the 1(st) disinfection (AP, 45; PA, 36, P = 0.262) or the 2(nd) disinfection (AP, 6; PA, 13, P = 0.157), suggesting that there is no relationship between disinfective power and the sequence of the disinfectants used. The number of positive cultures significantly decreased after the 2(nd) disinfection (P < 0.01), however. There was no significant difference in disinfective power according to sterilization sequence with 70% isopropyl alcohol and 10% PVP-I in healthy volunteers. The combination of 70% isopropyl alcohol and 10% PVP-I was more effective than disinfection with a single agent regardless of sterilization sequence.
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