Document Detail

A randomized controlled trial of the impact of chlorhexidine skin cleansing on bacterial colonization of hospital-born infants in Nepal.
MedLine Citation:
PMID:  18449064     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Chlorhexidine skin cleansing might substantially reduce neonatal infection and mortality in developing countries. Few data exist on the impact of chlorhexidine cleansing on skin colonization of infants during the first day of life or on the absorption potential of chlorhexidine during newborn skin cleansing.
METHODS: Hospital-born newborns in Kathmandu, Nepal were randomly allocated to full-body skin cleansing with 0.25%, 0.50%, or 1.00% chlorhexidine solution. Skin swabs were collected from the axilla, inguinal, and peri-umbilical areas before cleansing (baseline), and at 2 and 24 hours after treatment. Skin flora was quantified and organisms identified. In a subsample, heel prick blood was collected 24 hours after the cleansing and percutaneous absorption of chlorhexidine was assessed.
RESULTS: Among 286 enrolled newborns, no adverse effects on skin were reported and body temperature was minimally reduced (mean reduction, 0.33 degrees C). In all groups, positive skin culture rates were significantly reduced at 2 hours but generally not at 24 hours; greater reductions were observed with higher concentrations of chlorhexidine. Effect at 24 hours was highest in the 1.00% group (37% lower positive skin culture rate). For 15 of 75 infants with heel pricks, chlorhexidine was detected at trace concentrations (<8 ng/mL, n = 14; 25.8 ng/mL, n = 1).
CONCLUSIONS: Chlorhexidine skin cleansing seemed safe and reduced skin flora in newborns in a dose-dependent manner 2 hours after treatment. Greater residual effect at the highest concentration (1%) might provide broader benefit and may simplify combined maternal and neonatal regimens by matching the concentration used for vaginal cleansing during labor.
Luke C Mullany; Subarna K Khatry; Jeevan B Sherchand; Steven C LeClerq; Gary L Darmstadt; Joanne Katz; Punita Gauchan; Ramesh K Adhikari; Ashma Rana; James M Tielsch
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  27     ISSN:  0891-3668     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-06     Completed Date:  2008-07-03     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  505-11     Citation Subset:  IM    
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MeSH Terms
Anti-Infective Agents, Local / adverse effects,  blood,  therapeutic use*
Bacteria / classification,  isolation & purification*
Blood Chemical Analysis
Chlorhexidine / adverse effects,  blood,  therapeutic use*
Colony Count, Microbial
Infant, Newborn
Skin / microbiology*
Skin Diseases, Bacterial / prevention & control*
Grant Support
HD 38753/HD/NICHD NIH HHS; HD 44004/HD/NICHD NIH HHS; P30 CA13148/CA/NCI NIH HHS; R01 HD038753/HD/NICHD NIH HHS; R01 HD038753-01/HD/NICHD NIH HHS; R01 HD038753-02/HD/NICHD NIH HHS; R01 HD038753-03/HD/NICHD NIH HHS; R01 HD038753-03S1/HD/NICHD NIH HHS; R01 HD038753-04/HD/NICHD NIH HHS; R01 HD044004/HD/NICHD NIH HHS; R01 HD044004-01/HD/NICHD NIH HHS; R01 HD044004-02/HD/NICHD NIH HHS; R01 HD044004-03/HD/NICHD NIH HHS
Reg. No./Substance:
0/Anti-Infective Agents, Local; R4KO0DY52L/Chlorhexidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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