New antiseptic may cut hospital infections
Last Updated: Thursday, January 7, 2010 | 6:32 PM ET
Getting your nose checked for bacteria and using a newer type of antiseptic may help to prevent infections during surgery, two studies have found.
Two studies in Thursday's New England Journal of Medicine looked at ways of cutting infection rates in hospital. In Canada, antibiotic-resistant hospital infections kill 8,000 patients each year — more than will die of breast cancer, AIDS and car accidents combined.
In a U.S. study, the overall rate of surgical-site infections a month after surgery was lower, 9.5 per cent, among 409 patients randomly assigned to receive a newer antiseptic, compared with 16.1 per cent for 440 patients who received the traditional iodine scrub.
The study's leader, Dr. Rabih Darouiche of the Michael DeBakey VA Medical Center in Houston, and a journal editorial writer, said they expect the newer antiseptic, known as chlorhexidine, to replace iodine.
Darouiche said both antiseptic preps work against a variety of germs, but the newer blue-tinted antiseptic works quicker and longer. It also costs more — on average $12 US versus $3 for the iodine prep — but Darouiche said the expense is outweighed when savings in costly infections are considered.
Baths and ointment
The second study looked at whether screening patients' noses for bacteria and treating those who were found to have staph offered any benefits for cutting infections.
The study looked at 917 mostly surgical patients in the Netherlands who tested positive for staph bacteria when they were admitted. They were treated with either mupirocin ointment, also known as Bactroban, twice daily and daily baths with antiseptic chlorhexidine soap or a placebo ointment and soap.
Over the next six weeks, about three per cent of the 504 patients in the treated group had staph infections compared with about eight per cent in the 413 patients in the placebo.
The baths and gel also reduced the average hospital stay by almost two days, Dr. Henri Verbrugh of the Erasmus University Medical Center in Rotterdam and his colleagues found.
The research offers "remarkably safer strategies for all patients who require surgery," Dr. Richard Wenzel of Virginia Commonwealth University in Richmond, Va., wrote in a journal editorial that accompanies the studies.
Wenzel said the chlorhexidine-alcohol mixture should replace the older disinfectant before surgery, and the nasal disinfection technique should mainly be used on patients most likely to be infected, such as those having heart surgery or receiving an implant.
The U.S. study was funded by CareFusion Corp., formerly part of Cardinal Health Inc., which makes the antiseptics tested. The researchers report getting grants and consulting fees from the company, and one is a company employee.
The Dutch study was funded by a number of drug makers and some of the researchers receive advisory board and lecture fees from them.With files from The Associated Press
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