Summary of findings 2. 4% chlorhexidine gluconate (CHG) compared to plain liquid soap for prevention of infection in neonates.
| 4% CHG compared to plain liquid soap for prevention of infection in neonates | ||||||
| Patient or population: nurses and neonates Setting: neonatal intensive care unit Intervention: 4% CHG Comparison: plain liquid soap | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with plain liquid soap | Risk with 4% CHG | |||||
| Adverse outcome (higher score is better) ‐ mean visual scoring of skin (mean score) | Mean adverse outcome (higher score is better) ‐ mean visual scoring of skin (mean score) was 0 | MD 1.75 lower (3.31 lower to 0.19 lower) | ‐ | 16 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b | Very small study. It was not reported if allocation was concealed, probably not done. Also it was not stated whether participants and assessors were blinded. Probably not done |
| Adverse outcome (higher score is better) ‐ mean hand self‐assessment (mean score) | Mean adverse outcome (higher score is better) ‐ mean hand self‐assessment (mean score) was 0 | MD 9.25 lower (12.29 lower to 6.21 lower) | ‐ | 16 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b | |
| Incidence of bacteriologically confirmed infection within the first 28 days of life | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| Incidence of (study author‐defined) suspected infection within the first 28 days of life | ‐ | ‐ | ‐ | ‐ | ‐ | Not reported |
| All‐cause 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 measured | ||||
| Any hospitalisation for neonates managed in the community setting | ‐ | ‐ | ‐ | ‐ | ‐ | Not measured |
| *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 to high risk of bias due to study limitations.
bWe downgraded by two levels for very serious imprecision due to very wide confidence intervals.