Chlorhexidine and povidone-iodine: Unmasking the unknown in catheter-related infection prevention, a narrative review
Healthcare-associated infections remain a major concern, with vascular access devices contributing substantially to infection risk. Effective skin disinfection is essential for preventing catheter-related infections (CRIs). This narrative review compares the efficacy and safety of chlorhexidine gluc...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-09-01
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| Series: | Journal of Infection and Public Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S187603412500200X |
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| author | Bertrand Drugeon Claire M. Rickard Jessica A. Schults Jérémy Guenezan Olivier Mimoz |
| author_facet | Bertrand Drugeon Claire M. Rickard Jessica A. Schults Jérémy Guenezan Olivier Mimoz |
| author_sort | Bertrand Drugeon |
| collection | DOAJ |
| description | Healthcare-associated infections remain a major concern, with vascular access devices contributing substantially to infection risk. Effective skin disinfection is essential for preventing catheter-related infections (CRIs). This narrative review compares the efficacy and safety of chlorhexidine gluconate (CHG) and povidone-iodine (PVI), while also addressing often-underexamined factors such as product availability, application techniques, antimicrobial resistance and environmental impact. Evidence supports the use of 2 % CHG in 70 % isopropyl alcohol as the most effective strategy to reduce CRIs, although PVI remains an alternative in patients with CHG intolerance or in low-resource settings. Environmental analyses highlight the higher persistence and potential ecological risk of CHG compared with PVI. Despite widespread guidelines, significant discrepancies persist in recommended concentrations, application methods, and target populations. Based on literature synthesis, we propose standardising the use of 2 % CHG-IPA where feasible, developing tailored recommendations for high-risk groups, and incorporating environmental and economic considerations into future infection prevention strategies. |
| format | Article |
| id | doaj-art-26551c39efbb4b2c8dfae1dda79903b0 |
| institution | Kabale University |
| issn | 1876-0341 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj-art-26551c39efbb4b2c8dfae1dda79903b02025-08-20T03:42:03ZengElsevierJournal of Infection and Public Health1876-03412025-09-0118910285110.1016/j.jiph.2025.102851Chlorhexidine and povidone-iodine: Unmasking the unknown in catheter-related infection prevention, a narrative reviewBertrand Drugeon0Claire M. Rickard1Jessica A. Schults2Jérémy Guenezan3Olivier Mimoz4CHU de Poitiers, Service des Urgences Adultes – SAS 86 - SAMU, Poitiers, France; INSERM, U1070, Pharmacologie des Agents anti-Infectieux, Poitiers, France; Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia; School of Nursing, Midwifery and Social Work and Centre for Clinical Research, University of Queensland, Brisbane, Australia; Université de Poitiers, Faculté de Médecine et de Pharmacie, Poitiers, France; Corresponding author at: Service des urgences adultes et SAS 86 / SMUR, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France.Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia; School of Nursing, Midwifery and Social Work and Centre for Clinical Research, University of Queensland, Brisbane, Australia; Herston Infectious Diseases Institute, Metro North Health, Brisbane, AustraliaAlliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia; School of Nursing, Midwifery and Social Work and Centre for Clinical Research, University of Queensland, Brisbane, Australia; Herston Infectious Diseases Institute, Metro North Health, Brisbane, AustraliaCHU de Poitiers, Service des Urgences Adultes – SAS 86 - SAMU, Poitiers, France; INSERM, U1070, Pharmacologie des Agents anti-Infectieux, Poitiers, France; Université de Poitiers, Faculté de Médecine et de Pharmacie, Poitiers, FranceCHU de Poitiers, Service des Urgences Adultes – SAS 86 - SAMU, Poitiers, France; INSERM, U1070, Pharmacologie des Agents anti-Infectieux, Poitiers, France; Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Australia; Université de Poitiers, Faculté de Médecine et de Pharmacie, Poitiers, FranceHealthcare-associated infections remain a major concern, with vascular access devices contributing substantially to infection risk. Effective skin disinfection is essential for preventing catheter-related infections (CRIs). This narrative review compares the efficacy and safety of chlorhexidine gluconate (CHG) and povidone-iodine (PVI), while also addressing often-underexamined factors such as product availability, application techniques, antimicrobial resistance and environmental impact. Evidence supports the use of 2 % CHG in 70 % isopropyl alcohol as the most effective strategy to reduce CRIs, although PVI remains an alternative in patients with CHG intolerance or in low-resource settings. Environmental analyses highlight the higher persistence and potential ecological risk of CHG compared with PVI. Despite widespread guidelines, significant discrepancies persist in recommended concentrations, application methods, and target populations. Based on literature synthesis, we propose standardising the use of 2 % CHG-IPA where feasible, developing tailored recommendations for high-risk groups, and incorporating environmental and economic considerations into future infection prevention strategies.http://www.sciencedirect.com/science/article/pii/S187603412500200XSkin disinfectionChlorhexidinePovidone IodineVascular access |
| spellingShingle | Bertrand Drugeon Claire M. Rickard Jessica A. Schults Jérémy Guenezan Olivier Mimoz Chlorhexidine and povidone-iodine: Unmasking the unknown in catheter-related infection prevention, a narrative review Journal of Infection and Public Health Skin disinfection Chlorhexidine Povidone Iodine Vascular access |
| title | Chlorhexidine and povidone-iodine: Unmasking the unknown in catheter-related infection prevention, a narrative review |
| title_full | Chlorhexidine and povidone-iodine: Unmasking the unknown in catheter-related infection prevention, a narrative review |
| title_fullStr | Chlorhexidine and povidone-iodine: Unmasking the unknown in catheter-related infection prevention, a narrative review |
| title_full_unstemmed | Chlorhexidine and povidone-iodine: Unmasking the unknown in catheter-related infection prevention, a narrative review |
| title_short | Chlorhexidine and povidone-iodine: Unmasking the unknown in catheter-related infection prevention, a narrative review |
| title_sort | chlorhexidine and povidone iodine unmasking the unknown in catheter related infection prevention a narrative review |
| topic | Skin disinfection Chlorhexidine Povidone Iodine Vascular access |
| url | http://www.sciencedirect.com/science/article/pii/S187603412500200X |
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