Chlorhexidine bathing in a tertiary care neonatal intensive care unit: A pilot study

PLoS One. 2023 Mar 23;18(3):e0283132. doi: 10.1371/journal.pone.0283132. eCollection 2023.

Abstract

Background: Concerns regarding potential risk of dermal irritation have led to the exclusion of NICU patients from the recommendation regarding the use of 2% chlorhexidine gluconate (CHG) wash for daily skin cleansing to reduce bloodstream infections. Our aim was to assess the safety of 2% CHG bathing in NICU patients.

Methods: The regulator required a stepwise study enrollment to three successive groups: term infants, followed by near-term and pre-term infants. For comparison, we used a cohort of matched controls. A propensity score-adjusted regression model was used to compare the groups.

Intervention: Infants were bathed thrice-weekly with 2% CHG-impregnated washcloths. Participant's skin was examined daily.

Results: Over a total of 661 days of treatment: 384,129, and 148 days for the term, near-term and pre-term groups, respectively, no skin reactions were observed. The intervention group was generally sicker, however, bloodstream infections were similar between the groups.

Conclusion: For infants >30 weeks and >3 days old, 2% CHG bathing was safe. Large multicenter studies are urgently needed to establish the effectiveness of this practice in the NICU.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Infective Agents, Local* / therapeutic use
  • Baths
  • Chlorhexidine / adverse effects
  • Cross Infection* / prevention & control
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units
  • Intensive Care Units, Neonatal
  • Pilot Projects
  • Sepsis*
  • Tertiary Healthcare

Substances

  • chlorhexidine gluconate
  • Chlorhexidine
  • Anti-Infective Agents, Local

Grants and funding

We declare that MBM received a grant for the purpose of this work from “Mada’it” Fund, Shaare-Zedek Medical Center Research authority (grant # 20151512); and from the joint research Fund, Hebrew University and SZMC (grant #18002634). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.