Use of chlorhexidine for the prophylaxis of nosocomial infections in ICU

Abstract

This review summarizes published data on the use of chlorhexidine for the prevention of nosocomial infections in the intensive care units (ICU). The use of a 0.5–2.0% alcohol solution of chlorhexidine is strongly recommended for the surgical site decontamination before surgical intervention or vascular puncture for the prevention of surgical site infections and catheter-associated bloodstream infections. The following measures could be considered: daily skin decontamination with water solution of chlorhexidine (chlorhexidine bathing) in ICU for the prevention of catheter-associated bloodstream infection; the use of impregnated with chlorhexidine dressing for the prevention of catheter-associated bloodstream infections and catheter colonization; cleaning of the urinary meatus with water solution of chlorhexidine for the prevention of catheter-associated urinary tract infections. A routine use of chlorhexidine solution for oral care to prevent ventilator-associated pneumonia is not reasonable. The risks of contact dermatitis, anaphylaxis and emergence of chlorhexidine-resistant microorganisms should be considered when using chlorhexidine.