Skip to main content
Top
Published in: Intensive Care Medicine 12/2018

01-12-2018 | What's New in Intensive Care

Chlorhexidine use in adult patients on ICU

Authors: Lila Bouadma, Tarja Karpanen, Tom Elliott

Published in: Intensive Care Medicine | Issue 12/2018

Login to get access

Excerpt

Chlorhexidine (CHG) is a biguanide cationic antiseptic molecule, which has been incorporated into mouthwash solutions, dental gels, dressings, washcloths and central venous catheters (CVC). It has become the first-choice antiseptic to reduce healthcare-associated infections. However, the widespread use of CHG has raised concerns about increasing rates of resistance and cross-resistance to antibiotics. In this short review the antimicrobial characteristics of CHG including microbial resistance and its main clinical applications in ICU are presented. …
Literature
1.
go back to reference Williamson DA, Carter GP, Howden BP (2017) Current and emerging topical antibacterials and antiseptics: agents, action, and resistance patterns. Clin Microbiol Rev 30:827–860CrossRefPubMedPubMedCentral Williamson DA, Carter GP, Howden BP (2017) Current and emerging topical antibacterials and antiseptics: agents, action, and resistance patterns. Clin Microbiol Rev 30:827–860CrossRefPubMedPubMedCentral
2.
go back to reference Kampf G (2016) Acquired resistance to chlorhexidine—is it time to establish an “antiseptic stewardship” initiative? J Hosp Infect 94:213–227CrossRefPubMed Kampf G (2016) Acquired resistance to chlorhexidine—is it time to establish an “antiseptic stewardship” initiative? J Hosp Infect 94:213–227CrossRefPubMed
3.
go back to reference Wand ME, Bock LJ, Bonney LC, Sutton JM (2017) Mechanisms of increased resistance to chlorhexidine and cross-resistance to colistin following exposure of Klebsiella pneumoniae clinical isolates to chlorhexidine. Antimicrob Agents Chemother 61:e01162-16 Wand ME, Bock LJ, Bonney LC, Sutton JM (2017) Mechanisms of increased resistance to chlorhexidine and cross-resistance to colistin following exposure of Klebsiella pneumoniae clinical isolates to chlorhexidine. Antimicrob Agents Chemother 61:e01162-16
6.
go back to reference Loveday HP, Wilson JA, Pratt RJ et al (2014) epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect 86(Suppl 1):S1–S70CrossRefPubMed Loveday HP, Wilson JA, Pratt RJ et al (2014) epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect 86(Suppl 1):S1–S70CrossRefPubMed
7.
go back to reference Marschall J, Mermel LA, Fakih M et al (2014) Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 35(Suppl 2):S89–S107PubMed Marschall J, Mermel LA, Fakih M et al (2014) Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 35(Suppl 2):S89–S107PubMed
8.
go back to reference Timsit J-F, Mimoz O, Mourvillier B et al (2012) Randomized controlled trial of chlorhexidine dressing and highly adhesive dressing for preventing catheter-related infections in critically ill adults. Am J Respir Crit Care Med 186:1272–1278CrossRefPubMed Timsit J-F, Mimoz O, Mourvillier B et al (2012) Randomized controlled trial of chlorhexidine dressing and highly adhesive dressing for preventing catheter-related infections in critically ill adults. Am J Respir Crit Care Med 186:1272–1278CrossRefPubMed
9.
go back to reference Timsit J-F, Schwebel C, Bouadma L et al (2009) Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA 301:1231–1241CrossRefPubMed Timsit J-F, Schwebel C, Bouadma L et al (2009) Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA 301:1231–1241CrossRefPubMed
10.
go back to reference Hockenhull JC, Dwan KM, Smith GW et al (2009) The clinical effectiveness of central venous catheters treated with anti-infective agents in preventing catheter-related bloodstream infections: a systematic review. Crit Care Med 37:702–712CrossRefPubMed Hockenhull JC, Dwan KM, Smith GW et al (2009) The clinical effectiveness of central venous catheters treated with anti-infective agents in preventing catheter-related bloodstream infections: a systematic review. Crit Care Med 37:702–712CrossRefPubMed
11.
12.
go back to reference Labeau SO, Van de Vyver K, Brusselaers N et al (2011) Prevention of ventilator-associated pneumonia with oral antiseptics: a systematic review and meta-analysis. Lancet Infect Dis 11:845–854CrossRefPubMed Labeau SO, Van de Vyver K, Brusselaers N et al (2011) Prevention of ventilator-associated pneumonia with oral antiseptics: a systematic review and meta-analysis. Lancet Infect Dis 11:845–854CrossRefPubMed
13.
14.
go back to reference Klompas M, Speck K, Howell MD et al (2014) Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: systematic review and meta-analysis. JAMA Intern Med 174:751–761CrossRefPubMed Klompas M, Speck K, Howell MD et al (2014) Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: systematic review and meta-analysis. JAMA Intern Med 174:751–761CrossRefPubMed
15.
go back to reference Price R, MacLennan G, Glen J, SuDDICU Collaboration (2014) Selective digestive or oropharyngeal decontamination and topical oropharyngeal chlorhexidine for prevention of death in general intensive care: systematic review and network meta-analysis. BMJ 348:g2197CrossRefPubMedPubMedCentral Price R, MacLennan G, Glen J, SuDDICU Collaboration (2014) Selective digestive or oropharyngeal decontamination and topical oropharyngeal chlorhexidine for prevention of death in general intensive care: systematic review and network meta-analysis. BMJ 348:g2197CrossRefPubMedPubMedCentral
Metadata
Title
Chlorhexidine use in adult patients on ICU
Authors
Lila Bouadma
Tarja Karpanen
Tom Elliott
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 12/2018
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-018-5137-5

Other articles of this Issue 12/2018

Intensive Care Medicine 12/2018 Go to the issue