Chlorhexidine is a better antiseptic than povidone iodine and sodium hypochlorite because of its substantive effect

Macias, Juan H.; Arreguín, Virginia; Muñoz, Juan Manuel; Álvarez, José Antonio; Mosqueda, Juan L.; Macías, Alejandro E.

doi:10.1016/j.ajic.2012.10.002

Cited by 52 publications

(43 citation statements)

References 29 publications

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“…It is important to maintain skin antisepsis both during insertion and on an ongoing basis while the central line is in place [34]. The two most common antiseptic agents are povidone-iodine and chlorhexidine, which are available in both aqueous and alcoholic solutions.…”

Section: Skin Preparationmentioning

confidence: 99%

Eliminating Infections in the ICU: CLABSI

Latif

Halim

Pronovost

2015

Curr Infect Dis Rep

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Central line-associated bloodstream infections (CLABSI) are one of the leading causes of death in the USA and around the world. As a preventable healthcare-associated infection, they are associated with significant morbidity and excess costs to the healthcare system. Effective and long-term CLABSI prevention requires a multifaceted approach, involving evidence-based best practices coupled with effective implementation strategies. Currently recommended practices are supported by evidence and are simple, such as appropriate hand hygiene, use of full barrier precautions, avoidance of femoral lines, skin antisepsis, and removal of unnecessary lines. The most successful and sustained improvements in CLABSI rates further utilize an adaptive component to align provider behaviors with consistent and reliable use of evidence-based practices. Great success has been achieved in reducing CLABSI rates in the USA and elsewhere over the past decade, but more is needed. This article aims to review the initiatives undertaken to reduce CLABSI and summarizes the sentinel and recent literature regarding CLABSI and its prevention.

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Section: Skin Preparationmentioning

confidence: 99%

Eliminating Infections in the ICU: CLABSI

Latif

Halim

Pronovost

2015

Curr Infect Dis Rep

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“…3 Chlorhexidine (CHX) has been commonly used as a preferred antiseptic due to its quicker kill rate and broadspectrum biocide effectiveness with less risk for the occurrence of an opportunistic infection. 4,5 Besides CHX, silver has received substantial attention for centuries, thanks to its effective bactericidal activity and good biocompatibility. 6,7 In the past decade, a slew of silver-containing nanomaterials were fabricated.…”

Section: Introductionmentioning

confidence: 99%

Synergistic bactericidal activity of chlorhexidine-loaded, silver-decorated mesoporous silica nanoparticles

Lu¹,

Wang²,

Chang³

et al. 2017

IJN

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Combination of chlorhexidine (CHX) and silver ions could engender synergistic bactericidal effect and improve the bactericidal efficacy. It is highly desired to develop an efficient carrier for the antiseptics codelivery targeting infection foci with acidic microenvironment. In this work, monodisperse mesoporous silica nanoparticle (MSN) nanospheres were successfully developed as an ideal carrier for CHX and nanosilver codelivery through a facile and environmentally friendly method. The CHX-loaded, silver-decorated mesoporous silica nanoparticles (Ag-MSNs@CHX) exhibited a pH-responsive release manner of CHX and silver ions simultaneously, leading to synergistically antibacterial effect against both gram-positive Staphylococcus aureus and gram-negative Escherichia coli . Moreover, the effective antibacterial concentration of Ag-MSNs@CHX showed less cytotoxicity on normal cells. Given their synergistically bactericidal ability and good biocompatibility, these nanoantiseptics might have effective and broad clinical applications for bacterial infections.

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“…Alcoholic chlorhexidine performed consistently well or better than other disinfection agents in multiple studies [21,24,131,168,172,179,182]. In the research by Hong et al, a 5 second scrub with alcoholic chlorhexidine fully disinfected NC surfaces treated with Pseudomonas Aeruginosa [179].…”

Section: Disinfection Practicesmentioning

confidence: 99%

“…Research of Macias and associates with 2% chlorhexidine in 70% isopropyl alcohol on skin proved an added substantive effect, even against freshly introduced organisms, for up to 24 hours, establishing this agent as a superior disinfecting agent when longer action is needed, in comparison with single agents of 70% isopropyl alcohol, 10% povidone iodine and 10% sodium hypochlorite [172]. Alcoholic chlorhexidine performed consistently well or better than other disinfection agents in multiple studies [21,24,131,168,172,179,182].…”

Section: Disinfection Practicesmentioning

confidence: 99%

“…The major biocide effect of alcohol occurs while wet and immediately after drying, allowing for dehydration of bacterial cells, whereas alcoholic chlorhexidine is most effective during the drying process, where it enters the cell to cause destruction providing ongoing antimicrobial effect [150,172]. The disinfecting action of chlorhexidine in combination with alcohol, allowing for both immediate and sustained action; has proven to be more effective than either agent alone [21,131,168,172,176,[178][179][180]. Faster drying time with alcohol makes it superior to other disinfection agents and provides an advantage to chlorhexidine when used in combination.…”

Section: Disinfection Practicesmentioning

confidence: 99%

See 1 more Smart Citation

Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

Moureau¹

2015

Journal of the Association for Vascular Access

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Background. Needleless connectors (NC) are used on virtually all intravascular devices, providing an easy access point for infusion connection. Colonization of NC is considered the cause of 50% of postinsertion catheter-related infections. Breaks in aseptic technique, from failure to disinfect, result in contamination and subsequent biofilm formation within NC and catheters increasing the potential for infection of central and peripheral catheters. Methods. This systematic review evaluated 140 studies and 34 abstracts on NC disinfection practices, the impact of hub contamination on infection, and measures of education and compliance. Results. The greatest risk for contamination of the catheter after insertion is the NC with 33-45% contaminated, and compliance with disinfection as low as 10%. The optimal technique or disinfection time has not been identified, although scrubbing with 70% alcohol for 5-60 seconds is recommended. Studies have reported statistically significant results in infection reduction when passive alcohol disinfection caps are used (48-86% reduction). Clinical Implications. It is critical for healthcare facilities and clinicians to take responsibility for compliance with basic principles of asepsis compliance, to involve frontline staff in strategies, to facilitate education that promotes understanding of the consequences of failure, and to comply with the standard of care for hub disinfection.

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Chlorhexidine is a better antiseptic than povidone iodine and sodium hypochlorite because of its substantive effect

Cited by 52 publications

References 29 publications

Eliminating Infections in the ICU: CLABSI

Eliminating Infections in the ICU: CLABSI

Synergistic bactericidal activity of chlorhexidine-loaded, silver-decorated mesoporous silica nanoparticles

Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review

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