No benefit of chlorhexidine bathing in non-critical care units
Mimoz O, Guenezan J
The Lancet. 2019;393(10177):1179-80.
Chlorhexidine versus routine bathing to prevent multidrug-resistant organisms and all-cause bloodstream infections in general medical and surgical units (ABATE Infection trial): a cluster-randomised trial
Huang SS, Septimus E, Kleinman K, Moody J, Hickok J, Heim L, et al
The Lancet. 2019;393(10177):1205-15.
Mimoz and Guenezan's commentary on the article by Huang, observes that universal decolonisation has been advocated as a way to reduce health-care-associated infections and limit the transmission of multidrug-resistant organisms. The commonplace strategy has been bathing patients with chlorhexidine (a broad-spectrum antiseptic). This practice has been increasingly used in intensive care units (ICUs) globally. The efficacy of chlorhexidine baths has varied across different trials, with the greatest benefit seen among patients with the greatest risk of infection and few studies have examined the effect of this practice outside ICUs, in lower infection risk venues, and the findings have not been consistent.
Source: Critical Care stock
Huang et al report on the ABATE Infection trial that endeavored to evaluate the use of chlorhexidine bathing in non-critical-care settings. This trial was a cluster-randomised trial involving 53 hospitals and had a 12-month baseline period, a 2-month phase-in period, and a 21-month intervention period. The trial found little difference across the three periods, leading them to find that ‘Decolonisation with universal chlorhexidine bathing and targeted mupirocin for MRSA carriers did not significantly reduce multidrug-resistant organisms in non-critical-care patients.’
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