Nathorn Chaiyakunapruk, PharmD, PhD; David L. Veenstra, PharmD, PhD; Benjamin A. Lipsky, MD; Sanjay Saint, MD, MPH
Acknowledgments: The authors thank Gerard Sheehan, MD, John M. Conly, MD, Raphaele Girard, MD, Angela LeBlanc, BSc (Hed), and Valerie Knasinski, RN, for providing citations of additional studies or additional information from their studies. They also thank Todd A. Lee, PharmD, PhD, for helping with the abstraction of these studies.
Requests for Single Reprints: David L. Veenstra, PharmD, PhD, Pharmaceutical Outcomes Research and Policy Program, Department of Pharmacy, Box 357630, University of Washington, Seattle, WA 98195-7630; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Chaiyakunapruk: Department of Pharmacy Practice, School of Pharmacy, Naresuan University, Pitsanuloak 65000, Thailand.
Dr. Veenstra: Pharmaceutical Outcomes Research and Policy Program, Box 357630, University of Washington, Seattle, WA 98195-7630.
Dr. Lipsky: Veterans Affairs Puget Sound Health Care System (S-111-GIMC), 1660 South Columbian Way, Seattle, WA 98108-1597.
Dr. Saint: University of Michigan Medical School, Room 7E08, 300 NIB, Campus Box 0429, Ann Arbor, MI 48109-0429.
Author Contributions: Conception and design: D.L. Veenstra, S. Saint.
Analysis and interpretation of the data: N. Chaiyakunapruk, D.L. Veenstra, B.A. Lipsky, S. Saint.
Drafting of the article: N. Chaiyakunapruk, B.A. Lipsky.
Critical revision of the article for important intellectual content: N. Chaiyakunapruk, D.L. Veenstra, B.A. Lipsky, S. Saint.
Final approval of the article: N. Chaiyakunapruk, D.L. Veenstra, B.A. Lipsky, S. Saint.
Statistical expertise: N. Chaiyakunapruk, D.L. Veenstra.
Obtaining of funding: D.L. Veenstra, S. Saint.
Administrative, technical, or logistic support: N. Chaiyakunapruk.
Collection and assembly of data: N. Chaiyakunapruk.
Chaiyakunapruk N., Veenstra D., Lipsky B., Saint S.; Chlorhexidine Compared with Povidone-Iodine Solution for Vascular Catheter–Site Care: A Meta-Analysis. Ann Intern Med. 2002;136:792-801. doi: 10.7326/0003-4819-136-11-200206040-00007
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Published: Ann Intern Med. 2002;136(11):792-801.
Intravascular catheters are commonly used in caring for hospitalized patients but can lead to serious infectious complications (1). Catheter-related bloodstream infection is associated with increased morbidity, mortality, length of hospitalization, and medical costs (2-6). Use of an antiseptic solution for skin disinfection at the catheter insertion site helps prevent catheter-related infections. Povidone-iodine solution is the most commonly used agent for this purpose (7, 8).
Recently, several studies have compared the efficacy of povidone-iodine with that of chlorhexidine gluconate solutions for reducing vascular catheter–related infections (7, 9-14; Knasinski V, Maki DG. A prospective, randomized, controlled trial of 1% chlorhexidine 75% alcohol vs. 10% povidone iodine for cutaneous disinfection and follow-up site care with central venous and arterial catheters [Presented paper]. San Diego: National Association of Vascular Access Network Conference; 2000). Unfortunately, because few clinical events have been observed in individual studies, it remains unclear which antiseptic solution is best, both statistically and clinically, for reducing the risk for catheter-related bloodstream infection, particularly in patients with central-line catheters.
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