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.
Subject(s)
Anti-Infective Agents, Local/pharmacokinetics , Antisepsis , Catheterization, Peripheral , Chlorhexidine/analogs & derivatives , Infant, Premature , Skin Absorption/drug effects , Absorption , Anti-Infective Agents, Local/blood , Antisepsis/methods , Chlorhexidine/blood , Chlorhexidine/pharmacokinetics , Chromatography, Liquid , Female , Humans , Infant Care , Infant, Newborn , Male , Pilot Projects , Tandem Mass SpectrometryABSTRACT
Chlorhexidine gluconate (CHG) is a widely used topical antiseptic that is recommended by the Centers for Disease Control and Prevention for skin cleansing before central venous catheter insertion in adults and children. Because of limited safety data, CHG is not recommended for use in children <2 months of age. CHG is, however, frequently used in Neonatal Intensive Care Units across the United States. Here, we will review the safety of CHG use in preterm infants.
