Impact of Povidone-iodine Versus Chlorhexidine for Periurethral Cleaning Before Catheterization on Pyuria and Bacteriuria Among Emergency Department Patients

Abstract

Background: We aimed to determine the effect of periurethral cleaning before catheterization using chlorhexidine and povidone-iodine on bacteriuria and pyuria. Methods: This study was a single-blind clinical trial on a sample selected by convenience sampling. Demographic and clinical questionnaires were completed, and patients were randomly divided into two groups) 36 patients each of povidone-iodine and chlorhexidine using Minimization Software based on confounding variables including age, consciousness level, triage level, nutritional status, and underlying disease. The periurethral areas were cleaned with the given antiseptics and catheterized using standard and sterile procedures. Then, specimens were taken for urinalysis and urine culture immediately, 72 hours, and five days after catheterization. Then, bacteriuria rate, pyuria rate, and the number of microorganisms were determined through examinations. Data analysis was conducted using SPSS version 19. Results: There was no statistically significant difference in the bacteriuria rate between the two groups immediately (P = 0.76), 72 hours (P = 0.22), and five days (P = 0.50) after catheterization. The positive pyuria rate was not significantly different between the two groups immediately after catheterization. However, it was significantly higher in the povidone-iodine group 72 hours (P = 0.03) and five days (P = 0.004) after catheterization. The Mann-Whitney test compared the mean number of microorganisms between the two groups at different times. This test showed no significant difference in the number of microorganisms immediately (P = 0.93), 72 hours (P = 0.43), and five days (P = 0.61) after catheterization. Conclusions: Due to the lower side effects of chlorhexidine than povidone-iodine, it is suggested that similar studies be performed in other hospital wards with more stable patients to obtain more statistically significant results.

Microbiological Analysis of Surgeons’ Hands in a Public Hospital in São Luis, Maranhão State, Brazil: A Cross-Sectional Study

“…The chlorhexidine was the most efficient in hand antisepsis than other products, such as povidone-iodine (Figure 1). Some studies have shown that there are no differences between povidone and chlorhexidine in terms of effectiveness in reducing the bacterial flora of the skin; however, povidoneiodine has iodine-related clinical risks; it is more expensive, and the period of action is reduced in the presence of organic compounds [88]. On the other hand, chlorhexidine does not lose its effectiveness when exposed to blood and has a longer disinfecting effect on the skin, so it is often used for hand washing, and has shown lower rates of surgical infection [88][89][90].…”