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    Friday, April 9, 2010

    Which Antiseptic Is Best To Reduce The Risk Of Staph Infection?

    The chemical antiseptic chlorhexidine does a better job than povidone-iodine in reducing the risk of surgical site infections, even in carriers of Staphylococcus aureus, according to two new randomized studies.Researchers in the U.S. found that chlorhexidine and alcohol, used for preoperative skin cleansing, reduced infections by 41% compared with povidone-iodine.

    And Dutch investigators found that screening and decolonizing patients who are nasal carriers of S. aureus, combined with washing with chlorhexidine soap, reduced the risk of infection by 58%.

    The two prospective studies are reported in the New England Journal of Medicine and offer "valuable insights for controlling surgical-site infections. An accompanying editorial, wrote that the findings "offer remarkably safer strategies for all patients who require surgery."

    Overall, the researchers found, the rate of infection was 9.5% in the chlorhexidine group, compared with 16.1% in the povidone-iodine group. The chlorhexidine/alcohol scrub proved more protective against superficial incisional infections and deep incisional infections.

    The researchers concluded that better skin antisepsis could result in a "significant clinical benefit."

    The study is a "landmark", according to the University of Michigan Health Systems in Ann Arbor.If the study is eventually translated into national guidelines," the impact would be huge. That would include those undergoing cardiac surgery, patients receiving an implant, and those with a compromised immune system.

    In the Netherlands, researchers enrolled 808 people who were positive for S. aureus and underwent a surgical procedure that was expected to keep them in hospital for at least four days.

    They found:
    In the mupirocin/chlorhexidine group, 17 of 504 patients (or 3.4%) got an S. aureus infection, compared with 32 of 413 patients (or 7.7%) in the placebo group.

    The benefit was greatest for deep surgical-site infections, where the relative risk was 0.21, with a 95% confidence interval from 0.07 to 0.62.

    The time from admission to the onset of S. aureus infections was significantly shorter in the placebo group than in the mupirocin/chlorhexidine group, at P=0.005.
    The "weight of evidence" is now firmly on the side of chlorhexidine and alcohol as a preoperative skin cleansing, rather than povidone and iodine.

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

    Deepen your understanding of "medical malpractice"...

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