A randomized trial on chlorhexidine dressings for the prevention of catheter-related bloodstream infections in neutropenic patients

Abstract

NCT01544686 (Clinicaltrials.gov).

Local Cutaneous Effects Associated with Chlorhexidine-Impregnated Gel Dressing in Hematopoietic Stem Cell Transplantation Patients

“…A multicenter randomized trial on chlorhexidine dressings in neutropenic patients detected cutaneous abnormalities in 12.4% of patients using the dressing. Symptoms observed were erythema, pruritus, vesicles, and skin defects [16]. Thus, in accordance with the literature, our study demonstrates that CIGD is associated with a degree of injury to the skin in contact with it as we also observed some of these symptoms.…”

Central venous catheter–related bloodstream infections in patients with hematological malignancies: Comparison of data from a clinical registry and a randomized controlled trial

“…1,2 To reduce the burden of CRBSIs, many countries have implemented national surveillance programs. 3,4 Reliable epidemiological data are provided not only by cohort studies but also by randomized controlled trials (RCTs), [5][6][7] which are considered the gold standard for assessment of clinically relevant questions. 8 However, patient populations included in RCTs are often highly selected, limiting the generalizability of study results.…”

“…On the other hand, they are limited by substantial confounders and bias. 8 Our aim was to compare epidemiological data on CRBSIs in patients with hematological malignancies derived from a RCT (COAT, 6 ClinicalTrials.gov, no. NCT01544686) with data from a prospective registry (SECRECY, 9 German Clinical Trial Register, no.…”

“…The COAT trial was a RCT carried out from February 2012 to September 2014 in 10 hematology/oncology departments in Germany to compare 2 different types of CVC dressings with respect to the associated CRBSI incidence in neutropenic patients. 6 The SECRECY registry began in March 2013 and is an ongoing CRBSI registry, 9 now in 6 hematology/oncology departments in Germany. 10 In the present analysis, we included data from patients with nontunneled jugular and subclavian vein CVCs placed ≥1 day in situ.…”

Practice Guidelines for Central Venous Access 2020

“…Pooled estimates from RCTs are consistent with lower rates of catheter colonization with chlorhexidine sponge dressings compared with standard polyurethane (Category A1-B evidence) 90,[133][134][135][136][137][138] but equivocal for catheter-related bloodstream infection (Category A1-E evidence). 90,[133][134][135][136][137][138][139][140] An RCT reports a higher frequency of severe localized contact dermatitis in neonates with chlorhexidine-impregnated dressings compared with povidone-iodine-impregnated dressings (Category A3-H evidence) 133 ; findings concerning dermatitis from RCTs in adults are equivocal (Category A2-E evidence). 90,134,136,137,141 Survey Findings.…”