A comparison of chlorhexidine and povidone-iodine solutions in neonatal intensive care units.
Study Goal
The researchers aimed to compare the safety and efficacy of povidone-iodine (10%) versus 2% chlorhexidine in 70% isopropyl alcohol for neonatal use, focusing on infection prevention and thyroid function.
Results Summary
The study found that both disinfectants were equally protective against infections, but povidone-iodine was associated with higher TSH levels, indicating potential thyroid impairment, while chlorhexidine showed no adverse effects.
Population
Term and preterm infants hospitalized in a neonatal intensive care unit.
Effective Dosage
10% povidone-iodine and 2% chlorhexidine in 70% isopropyl alcohol (application frequency not specified).
Duration
Not specified (study period was July 2018-March 2020).
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Povidone-iodine (10%; PI) | no change | neonatal sepsis rates | term and preterm infants | not statistically different | were equally protective against infections | #1 |
2% chlorhexidine in 70% isopropyl alcohol (CHG-IA) | no change | neonatal sepsis rates | term and preterm infants | not statistically different | were equally protective against infections | #2 |
Povidone-iodine (10%; PI) | increase | median TSH value | term and preterm infants | 4.05 mIU/L | was high | #3 |
2% chlorhexidine in 70% isopropyl alcohol (CHG-IA) | neutral | median TSH value | term and preterm infants | 3.09 mIU/L | was | #4 |
2% chlorhexidine in 70% isopropyl alcohol (CHG-IA) | no change | cutaneous or neurological side effects | patients treated with CHG-IA solution | - | No cutaneous or neurological side effects were recorded | #5 |
Povidone-iodine (10%; PI) | decrease | thyroid function | - | - | may be responsible for impaired thyroid function | #6 |
BACKGROUND: Povidone-iodine (10%; PI) and 2% chlorhexidine in 70% isopropyl alcohol (CHG-IA) solutions are among the most widely used disinfectants in the neonatal intensive care units. This study compares the use of these disinfectants and helps decide which is superior to the other for neonatal use. METHODS: All term and preterm infants born and hospitalized in Bursa Uludag University Hospital between July 2018-March 2020 were included. The infants were randomized into two disinfectant groups before birth. The application site was cleaned with the assigned disinfectant before intervention. The infants were screened for rates of neonatal sepsis, thyroid-stimulating hormone (TSH) levels, free thyroxine (fT4) levels, skin reactions to the assigned solution, and acute neurological side effects. RESULTS: We enrolled 208 term and preterm infants (PI:104 vs. CHG-IA: 104) in the study. The prematurity rates were identical (PI: 74.0%; CHG-IA: 72.1%; p = 0.755). Neonatal sepsis rates among these groups were not statistically different (PI: 8.7%; CHG-IA: 4.8%; p = 0.406). The median TSH value of the PI group was high (4.05 mIU/L) in comparison with that of the CHG-IA group (3.09 mIU/L; p = 0.016). No cutaneous or neurological side effects were recorded in patients treated with CHG-IA solution. CONCLUSIONS: Although these two solutions were equally protective against infections, the CHG-IA solution was a better alternative to PI for neonatal use. Considering that the PI solution may be responsible for impaired thyroid function, the CHG-IA solution is a good alternative because it provides sufficient protection with a safer adverse effect profile.