In a prospective multicenter randomized controlled trial, Timsit et al. (Timsit et al 2009) demonstrated that use of chlorhexidine-impregnated sponges in dressings for intravascular catheters reduced rates of catheter-related bloodstream infections (CRI’s) by 60%, even in a population with a low baseline rate of CRI’s. The reduction was statistically significant, though the number needed to treat (NNT) to prevent one CRI for every catheter was 117. Significant contact dermatitis occurred in 10.4 per 1000 patients or 5.3 per 1000 catheters.
They also demonstrated that changing unsoiled adherent dressings could safely be done every 7 days rather than every 3 days.
The encouraging results were obtained even though most evidence-based practices were already in place to reduce the frequency of CRI’s.
Timsit J-F, Schwebel C, Bouadma L, et al for the Dressing Study Group. Chlorhexidine-Impregnated Sponges and Less Frequent Dressing Changes for Prevention of Catheter-Related Infections in Critically Ill Adults: A Randomized Controlled Trial. JAMA. 2009;301(12):1231-1241