Reduction of central line [catheter]–associated bloodstream infections (CLABSIs) is a priority for governing bodies within the United States. An abundance of evidence supports the use of chlorhexidine gluconate (CHG) as a topical antiseptic to reduce the colonization of harmful and antibiotic-resistant microorganisms. However, infants possess an immature epidermal layer that increases the likelihood of percutaneous drug or chemical absorption—especially for premature neonates and younger infants. Given the link between topical application of the antiseptic hexachlorophene and neurotoxicity in newborns, the Food and Drug Administration (FDA) cautions against the use of CHG in premature infants and those younger than 2 months. As such, little evidence is available that describes the safety profile of CHG application in infants less than 2 months of age.
Despite the paucity of evidence, use of CHG to prevent CLABSI in neonatal intensive care units is increasing around the United States. Therefore, the authors of this EBR...