Chlorhexidine skin or cord care for prevention of mortality and infections in neonates.

  title={Chlorhexidine skin or cord care for prevention of mortality and infections in neonates.},
  author={Anju Pradhan Sinha and Sunil Sazawal and Alok Pradhan and Siddarth Ramji and Newton Opiyo},
  journal={The Cochrane database of systematic reviews},
BACKGROUND Affordable, feasible and efficacious interventions to reduce neonatal infections and improve neonatal survival are needed. Chlorhexidine, a broad spectrum topical antiseptic agent, is active against aerobic and anaerobic organisms and reduces neonatal bacterial colonisation and may reduce infection. OBJECTIVES To evaluate the efficacy of neonatal skin or cord care with chlorhexidine versus routine care or no treatment for prevention of infections in late preterm or term newborn… 

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

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.

Efficacy of 4% chlorhexidine in preventing neonatal umbilical cord infection

4% Chlorhexidine was effective to lower omphalitis compared to neonates with dry cord care and prolonged mean cord separation time compared to dry care.

Effect of 4 % chlorhexidine on cord colonization among hospital and community births in India: a randomized controlled study

Cord cleansing with 4 % chlor hexidine soon after birth reduced colonization as well as density of colonization significantly; however this pilot study does not address the impact of chlorhexidine on mortality.

Effect of chlorhexidine cord application on prevention of neonatal sepsis in developing countries: Systematic review and meta-analysis

Chlorhexidine cord application significantly reduces neonatal sepsis and mortality in developing countries and the importance of including chlorhexidine Cord application into the essential newborn care in the setting with high burden of neonatal mortality is stressed.

Management of Newborn Infections During Inpatient Care

  • Medicine
  • 2019
It is estimated that more than 80% of infection-related deaths in newborns could be avoided if the coverage and quality of currently available preventive measures and effective interventions improved.

Effect of chlorhexidine cleansing on healthcare-associated infections in neonates: a systematic review and meta-analysis

It is shown that chlor hexidine cleansing could significantly reduce central line-associated bloodstream infection in neonates based on large-sample studies, and more studies are needed to determine the optimal concentration and frequency of chlorhexidine cleansing.

Chlorhexidine vaginal preparation versus standard treatment at caesarean section to reduce endometritis and prevent sepsis—a feasibility study protocol (the PREPS trial)

A parallel group feasibility randomised controlled trial comparing vaginal cleansing using chlorhexidine gluconate versus no cleansing at CS to reduce infection and develops women centred outcomes of wellbeing after delivery.

Application of 4% chlorhexidine to the umbilical cord stump of newborn infants in lower income countries: a systematic review and meta-analysis

This systematic review found that topical application of 4% chlorhexidine to the umbilical cord stump of newborn infants in lower income countries significantly reduces the incidence of neonatal mortality.

Colonization and infection in the newborn infant: Does chlorhexidine play a role in infection prevention?

Healthcare-associated infections are a major problem in newborn infants, considering their high morbidity, mortality, and long-term sequelae. In preterm infants, it has been shown that skin and



Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection.

The quality of the evidence using GRADE was very low for the outcomes of the comparison chlorhexidine (vaginal wash or gel/cream) versus placebo or no treatment, and the overall risk of bias was rated as unclear or high.

Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection.

Vaginal chlorhexidine resulted in a statistically significant reduction in GBS colonisation of neonates, but was not associated with reductions in other outcomes, and the review currently does not support the use of vaginal disinfection with chlor hexidine in labour for preventing EOD.

Vaginal chlorhexidine during labour for preventing maternal and neonatal infections (excluding Group B Streptococcal and HIV).

There is no evidence to support the use of vaginal chlorhexidine during labour in preventing maternal and neonatal infections, and there is a need for a well-designed randomized controlled trial using appropriate concentration and volume of vaginalchlorhexidine irrigation solution and with adequate sample size.

The use of chlorhexidine to reduce maternal and neonatal mortality and morbidity in low‐resource settings

Umbilical cord antiseptics for preventing sepsis and death among newborns.

Among studies conducted in hospital settings, no study reported data for mortality or tetanus, and there was no advantage of application of alcohol and triple dye for reduction of colonization with streptococcus.

Role of antimicrobial applications to the umbilical cord in neonates to prevent bacterial colonization and infection: a review of the evidence

The paucity of published reports from developing countries indicates the need to investigate the impact of antimicrobial applications on cord and systemic infections in a community-based, prospective manner.

A review of studies with chlorhexidine applied directly to the umbilical cord.

From the three studies it is now clear that with a minimum of one application of 4% chlorhexidine to the umbilical cord stump following delivery, the incidence of omphalitis and neonatal mortality can be reduced, especially in preterm newborns.

Use of Vaginally Administered Chlorhexidine During Labor to Improve Pregnancy Outcomes

With 4 million neonates and about 700,000 pregnant or recently pregnant women–mostly in developing countries–dying each year, many from infections originating in the vagina, further study of this highly promising treatment is indicated.