akinohanayuki ブログ

学位を持っても、センスのない、感染制御専門薬剤師のブログ.  I have Ph.D. but less sense ID pharmacist.

Lancetからクロルヘキシジンアルコールの報告

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「This new RCT found that chlorhexidine–alcohol was better than povidone iodine–alcohol for skin antisepsis before intravascular catheter insertion | Online First」

当院は去年からクロルヘキシジンアルコールを基本としました。なお、ショック症例は出ていません。

Skin antisepsis with chlorhexidine–alcohol versus povidone iodine–alcohol, with and without skin scrubbing, for prevention of intravascular-catheter-related infection (CLEAN): an open-label, multicentre, randomised, controlled, two-by-two factorial trial

Lancet 
Published Online: 17 September 2015


open-label, randomised controlled trial with a two-by-two factorial design

adults (age ≥18 years) admitted to one of 11 French intensive-care units and requiring at least one of central-venous, haemodialysis, or arterial catheters

1181 patients (2547 catheters) to chlorhexidine–alcohol (594 patients with scrubbing, 587 without) 
1168 (2612 catheters) to povidone iodine–alcohol (580 patients with scrubbing, 588 without). 

  • Chlorhexidine–alcohol was associated with lower incidence of catheter-related infections (0.28 vs 1.77 per 1000 catheter-days with povidone iodine–alcohol; hazard ratio 0.15, 95% CI 0.05–0.41; p=0.0002).

  • severe skin reactions occurred more frequently in those assigned to chlorhexidine–alcohol (27 [3%] patients vs seven [1%] with povidone iodine–alcohol; p=0.0017) and led to chlorhexidine discontinuation in two patients.