Use of chlorhexidine during labor: How effective against neonatal group B streptococci colonization?

Henneguin, Yves; Tecco, Laura; Vokaer, Alain

doi:10.3109/00016349509008931

Cited by 10 publications

(9 citation statements)

References 2 publications

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“…Published data on the effectiveness of CHX washing to reduce neonatal or maternal puerperal sepsis are conflicting. Several studies of CHX washings at various doses showed no benefit [4–7]. By contrast, 2 intervention trials involving over 11 000 women indicated that 0.25% CHX administered as a vaginal wash in labor and as a cleanse of the newborn skin immediately after delivery may be effective in reducing neonatal septic mortality [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Chlorhexidine (CHX) gluconate, an inexpensive antiseptic with broad antibacterial properties, has been studied as a possible means of reducing neonatal and maternal sepsis, but data from published trials have shown conflicting results [4–10]. Most recently, a randomized controlled trial (RCT) with 0.5% CHX failed to demonstrate an overall reduction in neonatal sepsis but reported a 42% CHX‐associated reduction in sepsis‐related mortality [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine

Pereira

Chipato

Mashu

et al. 2011

Intl J Gynecology & Obste

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine

Pereira

Chipato

Mashu

et al. 2011

Intl J Gynecology & Obste

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“…12 Conducting vaginal examinations during labor using surgical gloves lubricated with 1.0% chlorhexidine digluconate cream did not provide protection against vertical transfer of GBS compared with the use of nonlubricated gloves. 45 Although these data indicate that vaginal disinfection may reduce neonatal colonization with GBS, the low overall rates of early-onset GBS sepsis has precluded estimation of the impact on newborn infection. None of these studies was conducted in developing countries, and the validity of extrapolating the potential benefit to such settings is problematic.…”

Section: Vaginal Cleansingmentioning

confidence: 98%

Safety and Impact of Chlorhexidine Antisepsis Interventions for Improving Neonatal Health in Developing Countries

Mullany

Darmstadt

Tielsch

2006

The Pediatric Infectious Disease Journal

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Affordable, efficacious, and safe interventions to prevent infections and improve neonatal survival in low-resource settings are needed. Chlorhexidine is a broad-spectrum antiseptic that has been used extensively for many decades in hospital and other clinical settings. It has also been given as maternal vaginal lavage, full-body newborn skin cleansing, and/or umbilical cord cleansing to prevent infection in neonates. Recent evidence suggests that these chlorhexidine interventions may have significant public health impact on the burden of neonatal infection and mortality in developing countries. This review examines the available data from randomized and nonrandomized studies of chlorhexidine cleansing, with a primary focus on potential uses in low-resource settings. Safety issues related to chlorhexidine use in newborns are reviewed, and future research priorities for chlorhexidine interventions for neonatal health in developing countries are discussed. We conclude that maternal vaginal cleansing combined with newborn skin cleansing could reduce neonatal infections and mortality in hospitals of sub-Saharan Africa, but the individual impact of these interventions must be determined, particularly in community settings. There is evidence for a protective benefit of newborn skin and umbilical cord cleansing with chlorhexidine in the community in south Asia. Effectiveness trials in that region are required to address the feasibility of community-based delivery methods such as incorporating these interventions into clean birth kits or training programs for minimally skilled delivery assistants or family members. Efficacy trials for all chlorhexidine interventions are needed in low-resource settings in Africa, and the benefit of maternal vaginal cleansing beyond that provided by newborn skin cleansing needs to be determined.

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“…Also, data from a single study are rarely conclusive and should be put in the context of all available evidence 5. A brief search of the Cochrane Controlled Trials Register6 yielded citations of six possibly randomised studies evaluating vaginal cleansing with chlorhexidine 7 8 9 10 11 12. The most reliable guide for clinical practice and future research would be a systematic review of all relevant studies with adequate control of bias.…”

Section: Articlementioning

confidence: 99%

Commentary: Sources of bias must be controlled

Duley

1997

BMJ

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Use of chlorhexidine during labor: How effective against neonatal group B streptococci colonization?

Cited by 10 publications

References 2 publications

Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine

Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine

Safety and Impact of Chlorhexidine Antisepsis Interventions for Improving Neonatal Health in Developing Countries

Commentary: Sources of bias must be controlled

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