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7 December 1999 | Volume 131 Issue 11 | Pages 834-837
Background: Chlorhexidine is better than povidone-iodine for care of catheter sites, but it is not known whether chlorhexidine is superior in reducing blood culture contamination.
Objective: To determine whether alcoholic chlorhexidine is a more effective skin antiseptic for collection of blood cultures than aqueous povidone-iodine.
Design: Randomized, controlled trial.
Setting: Three adult intensive care units in a French university hospital.
Patients: 403 adults who had at least one blood culture drawn through a peripheral vein.
Interventions: Patients were randomly assigned to receive skin preparation with an aqueous solution of 10% povidone-iodine or an alcoholic solution of 0.5% chlorhexidine before phlebotomy.
Measurements: Contamination rates of blood cultures.
Results: Of 2041 blood cultures collected in 403 patients, 124 yielded pathogens. Chlorhexidine reduced the incidence of blood culture contamination more than povidone-iodine (14 of 1019 cultures [1.4%] compared with 34 of 1022 cultures [3.3%]; odds ratio, 0.40 [95% CI, 0.21 to 0.75]; P = 0.004).
Conclusion: Skin preparation with alcoholic chlorhexidine is more efficacious than skin preparation with aqueous povidone-iodine in reducing contamination of blood cultures.
Author and Article Information
From the Université Paris XI, Hôpital de Bicêtre, and Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre Cedex, France.
Acknowledgments: The authors thank the patients, physicians, and nurses of Hôpital Bicêtre for their cooperation and assistance.
Grant Support: By Zeneca Pharma and University Paris XI (UPRES, JE 2227).
Requests for Reprints: Olivier Mimoz, MD, PhD, Service d'Anesthésie-Réanimation, Hôpital Paul Brousse, 10 avenue Paul-Vaillant Couturier, 94809 Villejuif Cedex, France.
Current Author Addresses: Dr. Mimoz: Service d'Anesthésie-Réanimation, Hôpital Paul Brousse, 10 avenue Paul-Vaillant Couturier, 94809 Villejuif Cedex, France.
Drs. Karim, Cosseron, and Nordmann: Service de Bactériologie-Virologie, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre Cedex, France.
Drs. Mercat and Richard: Service de Réanimation Médicale, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre Cedex, France.
Dr. Falissard: INSERM-U472, Hôpital Paul Brousse, 16 avenue Paul-Vaillant Couturier, 94807 Villejuif Cedex, France.
Dr. Parker: Service de Neuro-Chirurgie, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre Cedex, France.
Dr. Samii: Service d'Anesthésie-Réanimation Chirurgicale, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre Cedex, France. BRIEF COMMUNICATION
Chlorhexidine Compared with Povidone-Iodine as Skin Preparation before Blood Culture
A Randomized, Controlled Trial
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