Antiseptic use in the neonatal intensive care unit-a dilemma in clinical practice: An evidence based review  

作　　者：Sundar Sathiyamurthy Jayanta Banerjee Sunit V Godambe 

机构地区：[1]Children’s Directorate, Department of Neonatal Medicine, Imperial College Healthcare NHS Trust

出　　处：《World Journal of Clinical Pediatrics》2016年第2期159-171,共13页世界临床儿科杂志

摘　　要：Infants in the neonatal intensive care unit are highly susceptible to healthcare associated infections(HAI), with a substantial impact on mortality, morbidity and healthcare costs. Effective skin disinfection with topical antiseptic agents is an important intervention in the prevention or reduction of HAI. A wide array of antiseptic preparations in varying concentrations and combinations has been used in neonatal units worldwide. In this article we have reviewed the current evidence of a preferred antiseptic of choice over other agents for topical skin disinfection in neonates. Chlorhexidine(CHG) appears to be a promising antiseptic agent; however there exists a significant concern regarding the safety of all agents used including CHG especially in preterm and very low birth weight infants. There is substantial evidence to support the use of CHG for umbilical cord cleansing and some evidence to support the use of topical emollients in reducing the mortality in infants born in developing countries. Well-designed large multicentre randomized clinical trials are urgently needed to guide us on the most appropriate and safe antiseptic to use in neonates undergoing intensive care, especially preterm infants.Infants in the neonatal intensive care unit are highly susceptible to healthcare associated infections(HAI), with a substantial impact on mortality, morbidity and healthcare costs. Effective skin disinfection with topical antiseptic agents is an important intervention in the prevention or reduction of HAI. A wide array of antiseptic preparations in varying concentrations and combinations has been used in neonatal units worldwide. In this article we have reviewed the current evidence of a preferred antiseptic of choice over other agents for topical skin disinfection in neonates. Chlorhexidine(CHG) appears to be a promising antiseptic agent; however there exists a significant concern regarding the safety of all agents used including CHG especially in preterm and very low birth weight infants. There is substantial evidence to support the use of CHG for umbilical cord cleansing and some evidence to support the use of topical emollients in reducing the mortality in infants born in developing countries. Well-designed large multicentre randomized clinical trials are urgently needed to guide us on the most appropriate and safe antiseptic to use in neonates undergoing intensive care, especially preterm infants.

关 键 词：ANTISEPTICS DISINFECTANTS Topical Neonate PRETERM Very low birth weight infant CHLORHEXIDINE POVIDONE-IODINE Alcohol 

分 类 号：R722.1[医药卫生—儿科]