Chlorhexidine gluconate wipes for infection prevention in acute and critical care

Each of the five adult intensive care units (ICUs) was randomized at the start of the study to either the intervention or control treatment for 10 weeks followed by a two-week washout period and a crossover to the other treatment; each ICU switched three times, for a total of four 10-week periods of alternating intervention and control treatments. [...] In contrast, Chlorhexidine Wipes for Infection Prevention in Acute and Critical Care 5 the systematic review and meta-analysis by O’Horo et al.8 described the characteristics of the individual studies in sufficient detail, and the conclusions acknowledged the limitations of the findings due to their derivation from non-randomized studies. [...] Additional strengths of this review were the statistical and graphical assessment of publication bias, and the provision of funding information and conflict of interest declarations for the individual studies and the review authors.8 Limitations common to both meta-analyses were the lack of an a priori published research objectives or a protocol, as well as the absence of an excluded studies list. [...] The participants were not blinded to the intervention in any of the studies, but the outcome assessors were blinded in the two RCTs.9,10 It was unclear whether outcome assessors in the non-randomized study11 were unaware of the treatment groups; blinding those analyzing data is feasible and would reduce the chance of bias in the direction of the intervention. [...] No relevant studies were identified regarding the clinical effectiveness of CHG wipes for infection prevention in adult patients in acute care, or regarding the cost-effectiveness of the use of CHG wipes in acute or critical care settings; therefore, no summary can be provided for these questions.