Chlorhexidine bathing for infection control in critical care patients: Uncertain if it is better than soap and water

Added March 16, 2020

Citation: Lewis SR, Schofield-Robinson OJ, Rhodes S, et al. Chlorhexidine bathing of the critically ill for the prevention of hospital-acquired infection. Cochrane Database of Systematic Reviews 2019; (8): CD012248.

What is this? Some patients with COVID-19 will become critically ill, requiring treatment in an intensive care unit (ICU). Hospital-acquired infections (HAI) among such patients can lead to longer stays in the ICU, as well as causing permanent disability or death. Chlorhexidine is widely uses as a disinfectant. It is sometimes used to bathe critically ill people, to kill bacteria and reduce the spread of HAI.

In this Cochrane systematic review, the authors searched for randomized trials comparing bathing of critically ill ICU patients with chlorhexidine versus soap and water. They did not restrict by date, study setting or language of publication and did their searches in December 2018. They identified 4 individually randomized trials (1537 participants) and 4 cluster randomized cross-over studies (23 randomized ICUs with 22,935 participants). The studies compared bathing patients with 2% chlorhexidine-impregnated washcloths or dilute solutions of 4% chlorhexidine versus soap and water or non-antimicrobial washcloths.

What works: Nothing reported.

What doesn’t work: Nothing reported.

What’s uncertain: It is uncertain if bathing with chlorhexidine is better than soap and water for reducing HAI, death or length of ICU stay.


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