Abstract
Objective This article assesses the degree of variability in the current practice of skin antiseptics
used in Canadian neonatal intensive care units (NICUs) and different experiences related
to each antiseptic used.
Methods An anonymous survey was distributed to a clinical representative of each of the 124
Canadian level II and level III NICUs.
Results One hundred and two respondents (82.2%), representing all Canadian provinces, completed
the survey. Chlorhexidine gluconate with/without alcohol was the antiseptic most used
(96%) and the antiseptic with the highest reported adverse effects (68% reported skin
burns/breakdown). Other antiseptics used include povidone-iodine (35%) and isopropyl
alcohol (22%). Specific guidelines for antiseptic use were available in only 50% of
the units with many NICUs lacking gestational and/or chronological age restrictions.
Only 23% of responders believed that there was awareness among health care providers
of the adverse effects of antiseptics used. Less than half (43%) were completely satisfied
with the antiseptics used in their units.
Conclusion Chlorhexidine gluconate is the most commonly used antiseptic in Canadian NICUs. The
high number of associated adverse effects and the lack of guidelines regulating antiseptic
use are of concern. Large clinical trials are urgently needed to guide practice and
improve the safety of antiseptics.
Keywords
anti-infective agents - newborn/premature infants - skin antiseptics
