Effectiveness of Chlorhexidine in Prevention of Umbilical Sepsis: A Hospital Based Study

Abstract

BACKGROUND: Umbilical sepsis is an important cause of neonatal morbidity and mortality. Severe omphalitis necessitates the administration of parenteral antibiotics with a consequent prolongation of hospital stay. AIMS: To assess whether simple protocolised interventions for cord care with locally available chlorhexidine is effective in reducing the incidence of umbilical sepsis. METHODS: This is a retrospective study. A protocol was introduced for daily cord care using 0.5% chlorhexidine gluconate followed by cleaning with sterile water for all newborns in Government Medical College, Ernakulam (formerly Cooperative Medical College, Kochi, Kerala). The incidence and severity of omphalitis was audited for a 3 month period subsequent to this practice change and was compared with the incidence of omphalitis during the same 3 month period in the preceding year. RESULTS: Eighty six babies were in the pre-intervention group and seventy seven in the chlorhexidine group were compared and both the groups were similar with respect to gestational age, sex, mode of delivery and parenteral antibiotic use. There was a significant difference with regard to the overall incidence of omphalitis after chlorhexidine use. Incidence of omphalitis was 44% in the pre-intervention group as compared to 6.5% in the chlorhexidine group (p value<0.05). CONCLUSION: Local administration of 0.5% chlorhexidine is effective in preventing umbilical sepsis.