Absorption and tolerability of aqueous chlorhexidine gluconate used for skin antisepsis prior to catheter insertion in preterm neonates

Objective:to assess chlorhexidine absorption and skin tolerability in premature infants, following skin antisepsis with 2% aqueous chlorhexidine gluconate (chg) prior to peripherally inserted central catheter (picc) placement.study design:neonates less than 32 weeks gestation had skin cleansed with chg prior to picc placement. chg concentrations were measured on serial blood samples. skin integrity was evaluated for 2 weeks after chg exposure.result:twenty infants were enrolled; median gestational age was 28 2/7 weeks (range 24 3/7 to 31 4/7). ten infants had detectable serum chlorhexidine concentrations (range 1.6 to 206 ng ml−1). seven of these infants had their highest serum concentration 2 to 3 days following exposure. no chg-related skin irritation occurred in any infant.conclusion:chg was detected in the blood of preterm infants receiving chg skin antisepsis for picc insertion. highest serum concentrations occurred 2 to 3 days after exposure. further investigation is needed to determine the clinical relevance of chg absorption in preterm infants.