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Absorption and tolerability of aqueous chlorhexidine gluconate used for skin antisepsis prior to catheter insertion in preterm neonates

Abstract

Objective:

To assess chlorhexidine absorption and skin tolerability in premature infants, following skin antisepsis with 2% aqueous chlorhexidine gluconate (CHG) prior to peripherally inserted central catheter (PICC) placement.

Study Design:

Neonates less than 32 weeks gestation had skin cleansed with CHG prior to PICC placement. CHG concentrations were measured on serial blood samples. Skin integrity was evaluated for 2 weeks after CHG exposure.

Result:

Twenty infants were enrolled; median gestational age was 28 2/7 weeks (range 24 3/7 to 31 4/7). Ten infants had detectable serum chlorhexidine concentrations (range 1.6 to 206 ng ml−1). Seven of these infants had their highest serum concentration 2 to 3 days following exposure. No CHG-related skin irritation occurred in any infant.

Conclusion:

CHG was detected in the blood of preterm infants receiving CHG skin antisepsis for PICC insertion. Highest serum concentrations occurred 2 to 3 days after exposure. Further investigation is needed to determine the clinical relevance of CHG absorption in preterm infants.

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Acknowledgements

This manuscript was supported by Grant Number UL1 RR 025005 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research, and its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. We thank Dr Craig Hendrix, the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center NICU nursing staffs, the Johns Hopkins Bayview Medical Center Neonatal Nurse Practitioners, and the Johns Hopkins ICTR Navigators.

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Correspondence to A M Milstone.

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AM received grant support from Sage Products. The remaining authors declare no conflict of interest.

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Chapman, A., Aucott, S., Gilmore, M. et al. Absorption and tolerability of aqueous chlorhexidine gluconate used for skin antisepsis prior to catheter insertion in preterm neonates. J Perinatol 33, 768–771 (2013). https://doi.org/10.1038/jp.2013.61

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