Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: a meta-analysis

Ann Intern Med. 2002 Jun 4;136(11):792-801. doi: 10.7326/0003-4819-136-11-200206040-00007.


Purpose: Bloodstream infections related to use of catheters, particularly central-line catheters, are an important cause of patient morbidity, mortality, and increased health care costs. This study evaluated the efficacy of skin disinfection with chlorhexidine gluconate compared with povidone-iodine solution in preventing catheter-related bloodstream infection.

Data sources: Multiple computerized databases (1966 to 2001), reference lists of identified articles, and queries of principal investigators and antiseptic manufacturers.

Study selection: Randomized, controlled trials comparing chlorhexidine gluconate with povidone-iodine solutions for catheter-site care.

Data extraction: Using a standardized form, two reviewers abstracted data on study design, patient population, intervention, and incidence of catheter-related bloodstream infection from all included studies.

Data synthesis: Eight studies involving a total of 4143 catheters met the inclusion criteria. All studies were conducted in a hospital setting, and various catheter types were used. The summary risk ratio for catheter-related bloodstream infection was 0.49 (95% CI, 0.28 to 0.88) in patients whose catheter sites were disinfected with chlorhexidine gluconate instead of povidone-iodine. Among patients with a central vascular catheter, chlorhexidine gluconate reduced the risk for catheter-related bloodstream infection by 49% (risk ratio, 0.51 [CI, 0.27 to 0.97]).

Conclusions: These results suggest that incidence of bloodstream infections is significantly reduced in patients with central vascular lines who receive chlorhexidine gluconate versus povidone-iodine for insertion-site skin disinfection. Use of chlorhexidine gluconate is a simple and effective means of reducing vascular catheter-related infections.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Aged
  • Anti-Infective Agents, Local / therapeutic use*
  • Catheterization, Central Venous / adverse effects*
  • Chlorhexidine / analogs & derivatives*
  • Chlorhexidine / therapeutic use*
  • Disinfectants / therapeutic use*
  • Humans
  • Middle Aged
  • Povidone-Iodine / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Sensitivity and Specificity
  • Sepsis / prevention & control*
  • Solutions


  • Anti-Infective Agents, Local
  • Disinfectants
  • Solutions
  • Povidone-Iodine
  • chlorhexidine gluconate
  • Chlorhexidine