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Antimicrobial Trumps Soap and Water in the ICU

Cheryl Clark, for HealthLeaders Media, February 7, 2013

The verdict: Patients cleaned with chlorhexidine bathing were 23% less likely to get an infection with a multi-drug resistant organism than those cleaned without the antimicrobial.

"During the control period, when nonantimicrobial cloths were used, 165 new cases of MRSA (methicillin-resistant staphlococcus aureus or vancomycin-resistant enterococcus (VCE) acquisition were detected, as compared with 127 during the periods of bathing with chlorhexidine," the study said.

"The overall rate of hospital-acquired bloodstream infections was 4.78 cases per 1,000 patient-days with chlorhexidine bathing versus 6.60 cases per 1,000 patient-days with non-antimicrobial wash cloths."

Bloodstream infections also were reduced in the treated group, with 165 during the control period and 119 in the chlorhexidine period.

"The rate of hospital acquired bloodstream infections was 28% lower during the intervention period than during the control period."

The same was true for central catheter-associated bloodstream infections, which were 53% lower during the intervention period than during the control period. Catheter-associated fungal bloodstream infections also dropped.

"If our results are confirmed, topical use of chlorhexidine could be added to strategies to prevent fungal infections," the authors  wrote.

And the longer patients were hospitalized in each unit, the more the chlorhexidine wash worked better than the non-antimicrobacterial wash.

And despite concerns, there were no serious skin reactions, and no skin reactions at all were attributed to the chemical wash.

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