Houston Chronicle
A study led by a Houston researcher has found that a less-popular, but more-expensive surgery-site antiseptic is more effective at reducing infections than the most commonly used product.
The research, led by Dr. Rabih Darouiche and published in today's edition of theNew England Journal of Medicine, is prompting a local hospital — one of six across the country to participate in the seven-year study — to change its pre-surgery skin cleanser.
The first-of-its-kind study compared two surgery-site antiseptics — including the one most widely used in the United States to cleanse patients' skin before surgery — and found that the more expensive, less popular product reduces infections about 40 percent more than the other product does.
Research sites included Ben Taub General Hospital and the Michael E. DeBakey VA Medical Center.
Every year in the United States, 300,000 to 500,000 patients have surgical-site infections. Twenty to 30 percent of those infections are caused by staph and more than half of those infections come from bacteria already on the patient's skin.
The more-effective antiseptic — chlorhexidine-alcohol — is used for about 10 percent of U.S. surgeries, but the slightly higher price pales in comparison to the savings for avoiding costly infections, Darouiche said.
Since 2002, the Centers for Disease Control and Prevention has recommended chlorhexidine-alcohol to reduce vascular catheter-association bloodstream infections. Studies have shown the antiseptic is more effective than povidone-iodine for cleaning the entry site for those tiny needles used to move fluids through patients.
“This is a very powerful, quick and practical approach to prevent surgical-site infections,” said Darouiche, who practices at the DeBakey VA Medical Center and teaches at Baylor College of Medicine.
The study included 849 patients.
Most VA hospitals continue to use povidone-iodine to cleanse surgical sites, but because of the study, the DeBakey VA Medical Center is in the process of switching to chlorhexidine-alcohol, Darouiche said.
“The reason they use it is not just because it has been used for decades, but they use it because it's essentially cheap,” he said. An average surgery would require a $12 chlorhexidine-alcohol product. A similar povidone-iodine skin preparation costs about $3.
“You can save anywhere from $10 to $400 (in infection treatment costs) for each extra dollar you spend,” said Darouiche, an internist whose specialties include infectious disease and spinal cord injury medicine.
Neither officials at the hospitals nor CareFusion — the company that makes both antiseptic products — knew about the study results until they were released Wednesday afternoon, Darouiche said.
The company supplied researchers with ChloraPrep, a chlorhexidine-alcohol preoperative skin preparation, along with another product that contained povidone-iodine. The study was almost entirely funded through grants and consulting fees to researchers from Cardinal Health, which recently spun off CareFusion.
The research, led by Dr. Rabih Darouiche and published in today's edition of theNew England Journal of Medicine, is prompting a local hospital — one of six across the country to participate in the seven-year study — to change its pre-surgery skin cleanser.
The first-of-its-kind study compared two surgery-site antiseptics — including the one most widely used in the United States to cleanse patients' skin before surgery — and found that the more expensive, less popular product reduces infections about 40 percent more than the other product does.
Research sites included Ben Taub General Hospital and the Michael E. DeBakey VA Medical Center.
Every year in the United States, 300,000 to 500,000 patients have surgical-site infections. Twenty to 30 percent of those infections are caused by staph and more than half of those infections come from bacteria already on the patient's skin.
The more-effective antiseptic — chlorhexidine-alcohol — is used for about 10 percent of U.S. surgeries, but the slightly higher price pales in comparison to the savings for avoiding costly infections, Darouiche said.
Since 2002, the Centers for Disease Control and Prevention has recommended chlorhexidine-alcohol to reduce vascular catheter-association bloodstream infections. Studies have shown the antiseptic is more effective than povidone-iodine for cleaning the entry site for those tiny needles used to move fluids through patients.
“This is a very powerful, quick and practical approach to prevent surgical-site infections,” said Darouiche, who practices at the DeBakey VA Medical Center and teaches at Baylor College of Medicine.
The study included 849 patients.
Most VA hospitals continue to use povidone-iodine to cleanse surgical sites, but because of the study, the DeBakey VA Medical Center is in the process of switching to chlorhexidine-alcohol, Darouiche said.
“The reason they use it is not just because it has been used for decades, but they use it because it's essentially cheap,” he said. An average surgery would require a $12 chlorhexidine-alcohol product. A similar povidone-iodine skin preparation costs about $3.
“You can save anywhere from $10 to $400 (in infection treatment costs) for each extra dollar you spend,” said Darouiche, an internist whose specialties include infectious disease and spinal cord injury medicine.
Neither officials at the hospitals nor CareFusion — the company that makes both antiseptic products — knew about the study results until they were released Wednesday afternoon, Darouiche said.
The company supplied researchers with ChloraPrep, a chlorhexidine-alcohol preoperative skin preparation, along with another product that contained povidone-iodine. The study was almost entirely funded through grants and consulting fees to researchers from Cardinal Health, which recently spun off CareFusion.
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