[Critical review of the literature concerning the comparative use of two antiseptic solutions before intravascular or epidural catheterization]

Ann Fr Anesth Reanim. 2003 Nov;22(9):787-97. doi: 10.1016/j.annfar.2003.08.001.
[Article in French]

Abstract

Objectives: To analyze the most pertinent data from the literature concerning the use of an antiseptic solution before the elaboration of invasive procedures such as blood cultures, insertion of peripheral or central intravenous catheters, and arterial or epidural catheters, and to identify, if any, the "ideal" antiseptic or, at least, the most efficient.

Data sources: Review of the literature. Data collected from the Medline database concerning experimental, clinical and basic research studies published between 1966 and 2003 and a manual research of references of relevant papers.

Results: After a brief historic and pharmacological reminder, the results of experimental and clinical studies are presented. Concerning the clinical studies, they concerned almost exclusively iodine products and chlorhexidine. These comparative studies are classified according to the punction site and the antiseptic solution used.

Conclusion: Even if the in vitro studies favor iodine products, chlorhexidine in alcoholic solution seems more efficient than povidone iodine in aqueous solution in the clinical setting. Several explanations are suggested to understand the in vitro/in vivo discordances. The place of povidone iodine in alcoholic solution, whose performances on the healthy skin are similar to those of alcoholic chlorhexidine, is being in evaluation.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Alcohols
  • Anti-Infective Agents, Local*
  • Biguanides
  • Catheterization* / adverse effects
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Peripheral / adverse effects
  • Chlorhexidine*
  • Clinical Trials as Topic
  • Drug Resistance, Microbial
  • Drug Utilization
  • Epidural Space*
  • Humans
  • Infection Control / methods*
  • Iodine Compounds*

Substances

  • Alcohols
  • Anti-Infective Agents, Local
  • Biguanides
  • Iodine Compounds
  • Chlorhexidine