Cholorhexidine, octenidine or povidone iodine for catheter-related infections: a randomised controlled trial

Introduction

Protection of the catheter site by antimicrobial ointments is one of the most important factors in the prevention of infection [1, 2]. Povidone iodine, chlorhexidine gluconate and octenidine hydrochloride are the most common used agents for dressing. The purpose of this study is to compare the effects of povidone iodine, chlorhexidine gluconate and octenidine hydrochloride in preventing catheter-related infections.

Methods

The study was performed in an adult ICU. Fifty-seven patients who have arterial, central venous catheterization were eligible to be included in the study. Patients were randomized to receive 4% chlorhexidine gluconate (group I, n = 19), 10% povidone iodine (group II, n = 19) or octenidine hydrochlorodine (group II, n = 19) for cutaneous antisepsis.

Results

The clinical characteristics of the patients and the risk factors for infection were similar in the groups. There was a statistically significant difference between groups in catheter-related sepsis and colonization (P < 0.001). The documented catheter-related sepsis rate was 10.5% in the povidone iodine and octenidine hydrochlorodine groups. The catheter-related colonization rate was 26.3% in the povidone iodine group and 21.5% in the octenidine hydrochlorodine group. In the chlorhexidine group, there was no catheter-related sepsis or colonization.

Conclusion

Chlorhexidine is an effective disinfectant agent. The use of 4% chlorhexidine rather than 10% povidone iodine or octenidine hydrochlorodine for cutaneous disinfection before insertion of an intravascular device and for postinsertion site care can substantially reduce the incidence of catheter-related infection.