Chlorhexidine is a better antiseptic than povidone iodine and sodium hypochlorite because of its substantive effect

• Published in: American journal of infection control Vol. 41; no. 7; pp. 634 - 637
• Main Authors: Macias, Juan H., Arreguin, Virginia, Munoz, Juan M., Alvarez, Jose A., Mosqueda, Juan L., Macias, Alejandro E.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.2013; Elsevier; Mosby-Year Book, Inc
• Subjects: Administration, Topical; Adolescent; Adult; Anti-infecting agents; Anti-Infective Agents, Local - administration & dosage; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimicrobial agents; Antiseptics; Bacteria; Biguanides; Biological and medical sciences; Chlorhexidine - administration & dosage; Chlorine compounds; Colony Count, Microbial; Comparative studies; Effects; Epidemiology. Vaccinations; Female; General aspects; Hand Disinfection - instrumentation; Hand Disinfection - methods; Humans; Infection Control; Infectious Disease; Infectious diseases; Iodine compounds; Male; Medical sciences; Pharmacology. Drug treatments; Povidone-Iodine - administration & dosage; Preoperative Care; Skin - microbiology; Sodium Hypochlorite - administration & dosage; Young Adult; Chlorine compounds; Iodine compounds; Anti-infecting agents; Biguanides; Povidone iodine; Check; Guanidines; Prevention; Infection; Sodium; Antiseptic; Hypochlorites; Chlorhexidine; Disinfecting agent
• ISSN: 0196-6553; 1527-3296; 1527-3296
• DOI: 10.1016/j.ajic.2012.10.002

The present study compared both the antiseptic efficacy of sodium hypochlorite against that of chlorhexidine gluconate in isopropyl alcohol and the substantive effect of chlorhexidine, povidone iodine, and sodium hypochlorite. This was a 2-step study that included volunteers. In step 1, 4 skin areas were tested for bacteria in colony-forming units (CFU): 2 were controls to determine baseline bacteria or the effect of scrubbing, and 2 were treated with 10% hypochlorite or 2% chlorhexidine in isopropyl alcohol. Every subject was tested 4 times. The second step tested the substantive effect of 10% povidone-iodine and the aforementioned antiseptics. For the first step, 30 volunteers were studied, resulting in 120 determinations for each control and antiseptic. No differences between chlorhexidine gluconate (median 115 CFU/cm2) and sodium hypochlorite (median 115 CFU/cm2) were found. Both antiseptics were significantly different from rubbing control (317 CFU/cm2) and basal control (606 CFU/cm2). Only chlorhexidine showed a substantive effect. We consider that chlorhexidine gluconate in isopropyl alcohol, sodium hypochlorite, and povidone-iodine is equally effective for procedures that do not require a long action. However, chlorhexidine is desirable for procedures such as catheter insertion, skin preparation for surgery, or handwashing prior to surgery.