Blood stream infections associated with IV catheters and similar are a common cause of death in US hospitals. The Center for Disease Control (CDC) has recommended the use of 0.5% Chlorhexidine Gluconate on skin at the catheter exit site for the prevention of catheter-related blood stream infections. The two biggest causes of catheter related blood stream infections are exit site infections and access site contamination.
The use of a chlorhexidine gluconate sponge over the site of CVC insertion has been associated with a decrease in the frequency and cost of CLABSI. In a study involving 1,636 patients with venous and arterial catheters, Timsit and colleagues reported that chlorhexidine gluconate sponge placement at the site of catheter insertion substantially reduced the incidence of CLABSI (1.4 to 0.6 per 1,000 catheter days, hazard ratio 0.39, P<0.03). However, severe contact dermatitis was observed in eight low birth-weight infants (5.3 per 1,000 catheter days), and the potential for this adverse effect remains an important limitation in the use of chlorhexidine gluconate sponges in this population.
In a recent economic evaluation, chlorhexidine-impregnated sponge use in patients with CLABSI was estimated to save $197 per patient using a 3-day dressing change strategy vs. $83 using a 7-day standard dressing change strategy.
In another cost-benefit analysis, a hypothetical 400-bed hospital inserting 3,078 CVCs annually would avoid a projected average of 35 CLABSIs, 145 local infections, and 281 ICU days with the systematic use of a chlorhexidine-impregnated foam dressing; potential annual hospital net savings were projected at over $895,000. Owing to important differences in study design and outcomes involving primarily pediatric populations, current guidelines recommend the use of chlorhexidine-impregnated sponge dressings only in situations where the CLABSI rate is not decreasing despite adherence to other prevention measures (Category IB).
- Clinical costs associated with central line occlusions - M1–1334 utilizing Neutron to reduce clinical costs Rev01
- Genentech financial report 2015