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Chlorhexidine Compared with Povidone-Iodine Solution for Vascular Catheter–Site Care: A Meta-Analysis

Nathorn Chaiyakunapruk, PharmD, PhD; David L. Veenstra, PharmD, PhD; Benjamin A. Lipsky, MD; and Sanjay Saint, MD, MPH
[+] Article and Author Information

From Naresuan University, Pitsanuloak, Thailand; University of Washington and Veterans Affairs Puget Sound Healthcare System, Seattle, Washington; and University of Michigan and Ann Arbor Veterans Administration Medical Center, Ann Arbor, Michigan.


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, veenstra@u.washington.edu.

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.


Ann Intern Med. 2002;136(11):792-801. doi:10.7326/0003-4819-136-11-200206040-00007
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Use of chlorhexidine gluconate solution for care of catheter sites is significantly more effective than use of povidone-iodine solution for preventing vascular catheter–related infections. We estimate that for every 1000 catheter sites disinfected with chlorhexidine gluconate rather than povidone-iodine, 71 episodes of catheter colonization and 11 episodes of catheter-related bloodstream infection would be prevented.

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Figure 1.
Trial flow depicting the selection process of studies included in the meta-analysis.

RCT = randomized, controlled trial.

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Figure 2.
Analysis of catheter-related bloodstream infection in studies comparing chlorhexidine gluconate and povidone-iodine solutions for care of vascular catheter sites.P

The diamond indicates the summary risk ratio and 95% CI. Studies are ordered chronologically. The size of squares is proportional to the reciprocal of the variance of the studies. For the test for heterogeneity of treatment effect, > 0.2. *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.

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Summary for Patients

Antiseptics To Prevent Infection from Intravascular Catheters

The summary below is from the full report titled “Chlorhexidine Compared with Povidone-Iodine Solution for Vascular Catheter-Site Care: A Meta-Analysis.” It appears in the 4 June 2002 issue of Annals of Internal Medicine (volume 136, pages 792-801). The authors are N Chaiyakunapruk, DL Veenstra, BA Lipsky, and S Saint.

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