Chlorhexidine or povidone‑iodine: Which solution is more effective on skin colonization in neonates?

Abstract

Background: Infection control should be an integrated part of patient care, especially to ensure safety and survival in hospitalized neonates. Although povidone‑iodine (PVP‑I) solution has been used as the most common antiseptic in hospitals of Iran, chlorhexidine is currently used in some wards for skin disinfection. However, there is no evidence about the superiority of either antiseptic solution over the other one. This clinical trial carried out in two university hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, aimed to compare the effects of chlorhexidine and PVP‑I solutions on skin bacterial colonization in hospitalized neonates.

Materials and Methods: The participants were 98 hospitalized infants. In each infant, one area on the skin was disinfected by chlorhexidine while the contralateral site was disinfected by PVP‑I. Skin cultures were taken before and after disinfection. Microorganisms were determined and colony count was performed based on a standard method. The collected data were analyzed using descriptive and inferential statistical methods in SPSS v. 14.

Results: The mean of microorganism colony count before and after disinfection by either solution was statistically different (P < 0.001). There was no significant difference between the two groups in terms of mean microorganism colony count before disinfection. However, a significant difference was observed after disinfection.

Conclusions: PVP‑I is more efficacious than chlorhexidine for skin disinfection. Consequently, it seems better to use PVP‑I for skin preparation before invasive procedures.

Key words: Bacterial infection, chlorhexidine, disinfection, Iran, neonate, newborns, povidone‑iodine