Summary of findings 1. 2% chlorhexidine gluconate (CHG) compared to alcohol hand sanitiser (61% alcohol and emollients) for prevention of infection in neonates.
| 2% CHG compared to alcohol hand sanitiser (61% alcohol and emollients) for prevention of infection in neonates | ||||||
| Patient or population: prevention of infection in neonates Setting: neonatal intensive care unit Intervention: 2% CHG Comparison: alcohol hand sanitiser (61% alcohol and emollients) | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with alcohol hand sanitiser (61% alcohol and emollients) | Risk with 2% CHG | |||||
| Incidence of (study author‐defined) suspected infection within the first 28 days of life | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Incidence of bacteriologically confirmed infection (types of infection as specified by study authors) within the first 28 days of life ‐ all infections | Study population | RR 2.19 (1.79 to 2.69) | 2932 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b | Rates of patient contact differ significantly in the 2 groups and this is likely to affect outcomes | |
| 134 per 1000 | 294 per 1000 (240 to 361) | |||||
| All‐course mortality within the first 7 days of life (early neonatal death) | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| All‐cause mortality from the 8th to the 28th day of life (late neonatal death) | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Duration of hospital stay | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Incidence of community‐acquired infection and hospital‐acquired infection | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Adverse events (higher score is better) ‐ mean observers reported skin changes in nurses (mean score) | Mean adverse events (higher score is better) ‐ mean observers reported skin changes in nurses (mean score was 0) | MD 0.19 higher (0.03 higher to 0.35 higher) | ‐ | 120 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference; RCT: randomised controlled trial. | ||||||
| GRADE Working Group grades of evidence. High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aWe downgraded by two levels for very serious risk of bias due to study limitations.
bWe downgraded by one level for serious imprecision.