【medical-news】Lancet：每日洗必泰洗浴能降低危重患儿菌血症的发生率
这个帖子发布于 12 年零 242 天前，其中的信息可能已发生改变或有所发展。
Daily chlorhexidine bathing to reduce bacteraemia incritically ill children: a multicentre, cluster-randomised, crossover trial
Summary
Background Bacteraemia is an important cause of morbidity andmortality in critically ill children. Our objective was to assess whether dailybathing in chlorhexidine gluconate (CHG) compared with standard bathingpractices would reduce bacteraemia in critically ill children.
Methods In an unmasked, cluster-randomised, two-periodcrossover trial, ten paediatric intensive-care units at five hospitals in theUSA were randomly assigned a daily bathing routine for admitted patients olderthan 2 months, either standard bathing practices or using a cloth impregnatedwith 2% CHG, for a 6-month period. Units switched to the alternative bathingmethod for a second 6-month period. 6482 admissions were screened foreligibility. The primary outcome was an episode of bacteraemia. We didintention-to-treat (ITT) and per-protocol (PP) analyses. This study isregistered with ClinicalTrials.gov (identifi er NCT00549393).
Findings 1521 admitted patients were excluded because theirlength of stay was less than 2 days, and 14 refused to participate. 4947admissions were eligible for analysis. In the ITT population, a non-significant reduction in incidence of bacteraemia was noted with CHG bathing (3·52 per 1000 days, 95% CI 2·64–4·61) comparedwith standard practices (4·93 per 1000 days, 3·91–6·15; adjustedincidence rate ratio [aIRR] 0·71, 95% CI 0·42–1·20). In the PPpopulation, incidence of bacteraemia was lower in patients receiving CHGbathing (3·28 per 1000 days, 2·27–4·58) compared with standard practices (4·93 per 1000 days, 3·91–6·15; aIRR 0·64, 0·42–0·98). No seriousstudy-related adverse events were recorded, and the incidence of CHG-associatedskin reactions was 1·2 per 1000 days (95% CI 0·60–2·02).
Interpretation Critically ill children receiving daily CHGbathing had a lower incidence of bacteraemia compared with those receiving astandard bathing routine. Furthermore, the treatment was well tolerated.
Summary
Background Bacteraemia is an important cause of morbidity andmortality in critically ill children. Our objective was to assess whether dailybathing in chlorhexidine gluconate (CHG) compared with standard bathingpractices would reduce bacteraemia in critically ill children.
Methods In an unmasked, cluster-randomised, two-periodcrossover trial, ten paediatric intensive-care units at five hospitals in theUSA were randomly assigned a daily bathing routine for admitted patients olderthan 2 months, either standard bathing practices or using a cloth impregnatedwith 2% CHG, for a 6-month period. Units switched to the alternative bathingmethod for a second 6-month period. 6482 admissions were screened foreligibility. The primary outcome was an episode of bacteraemia. We didintention-to-treat (ITT) and per-protocol (PP) analyses. This study isregistered with ClinicalTrials.gov (identifi er NCT00549393).
Findings 1521 admitted patients were excluded because theirlength of stay was less than 2 days, and 14 refused to participate. 4947admissions were eligible for analysis. In the ITT population, a non-significant reduction in incidence of bacteraemia was noted with CHG bathing (3·52 per 1000 days, 95% CI 2·64–4·61) comparedwith standard practices (4·93 per 1000 days, 3·91–6·15; adjustedincidence rate ratio [aIRR] 0·71, 95% CI 0·42–1·20). In the PPpopulation, incidence of bacteraemia was lower in patients receiving CHGbathing (3·28 per 1000 days, 2·27–4·58) compared with standard practices (4·93 per 1000 days, 3·91–6·15; aIRR 0·64, 0·42–0·98). No seriousstudy-related adverse events were recorded, and the incidence of CHG-associatedskin reactions was 1·2 per 1000 days (95% CI 0·60–2·02).
Interpretation Critically ill children receiving daily CHGbathing had a lower incidence of bacteraemia compared with those receiving astandard bathing routine. Furthermore, the treatment was well tolerated.
2 收藏1
