Many intensive care units use daily chlorhexidine bathing as a way to decolonize patients to prevent healthcare-associated infections and transmission of drug-resistant germs, but a recent study highlighted in a JAMA editorial proves this practice may be ineffective.
Researchers conducted a randomized study of 9,340 patients admitted to five ICUs at Vanderbilt University Medical Center in Nashville. They assigned some ICUs to bathe their patients once a day with a disposable cloth impregnated with 2 percent chlorhexidine, and others to bathe patients with nonantimicrobial cloths as the control units. The treatments went on for 10 weeks, and each ICU was crossed over three times between intervention and control bathing treatments to facilitate better balance of patient case mixes.
They found that daily chlorhexidine bathing did not reduce the composite rate of central line-associated bloodstream infections, ventilator-associated pneumonia, catheter-associated urinary tract infections or Clostridium difficile infection.
In the editorial, the authors note that the ICUs in question already had low infection rates, so ICUs with higher rates of infection may benefit more from implementing daily chlorhexidine bathing.
However, the authors note, "The current study…suggests that widespread adoption of daily chlorhexidine bathing is not indicated at this point…Rather, for institutions with infection rate similar to those reported in the current study, a simpler, less expensive approach that focuses on basic hygiene practices seems best."