January 7, 2010

Post-Surgery Infections Curbed With Antiseptic

Researchers have found that patients who are bathed with an antiseptic and have medicated ointment sprayed into their nostrils have a much better chance of fighting off deadly staph infections after surgery, according to the Associated Press.

The study found that antiseptic did a better job of preventing infections than the iodine solution that has been the mainstay for decades.

Infections are a troublesome problem in hospitals. Of the 30 million surgeries performed each year, as many as half a million Americans develop surgical-site infections, largely from staph bacteria. While health care workers can spread a lot of bugs, patients can also contaminate themselves with germs that are living on their skin and in their noses.

"A lot of people think it's all from the outside world, but these are your own germs," said Dr. Robert Weinstein, an infectious disease expert at Cook County's Stroger Hospital in Chicago.

According to research from one US study led by Dr. Rabih Darouiche, of the Michael DeBakey VA Medical Center in Houston, a newly tested antiseptic that could possibly replace the iodine solution commonly used to prep patients was found to cut all surgical-site infections by 40 percent.

The newer antiseptic prep is already being used in the Netherlands. Researchers there treated patients with both the antiseptic and nasal spray and found that the dual treatments reduced staph infections by nearly 60 percent. The researchers had tested the ointment before with mixed-results. A positive outcome would come from the development of rapid screenings, antiseptic baths and continuing treatment for as many as five days.

The study was carried out at five Netherland hospitals and involved 917 patients who tested positive for staph bacteria when they were admitted. They were treated twice daily with either mupirocin ointment and daily baths with chlorhexidine soap or a dummy ointment and plain soap. After six weeks, only 3 percent of the treated group still had infections compared to 8 percent of the untreated group. Treatment also cut hospital stays by two days.

A study at six US hospitals included 849 patients who were having surgeries with a moderate risk for infection. The surgical area was cleaned with either the usual iodine scrub or a mixture of chlorhexidine and alcohol. Four weeks later, the overall infection rate in the chlorhexidine group was about 10 percent compared to 16 percent for iodine.

Darouiche said that both preps work against a host of germs but the newer antiseptic works faster and longer. It is more expensive to use - twelve dollars compared to the three dollar iodine prep - but the expense far compensates for the thousands of patients who are saved by preventing costly staph infections.

According to Dr. Richard Wenzel, who wrote an editorial on the studies, said the US research supports using the newer antiseptic over the iodine swab. However, he said that pre-screening should be for those at a high risk of infection, including patients who are having heart surgery or implants.

Wenzel added that patients should inquire about infection rates connected with their hospital and doctor. Guidelines for prevention of serious infections call for antibiotics to be used just before surgery and for hair to be clipped rather than shaved. The safety offered by the new antibiotics are beneficial for "all patients who require surgery," he said.

The US study was funded by CareFusion Corp., formerly part of Cardinal Health Inc. The company offered grants and consulting fees. The Dutch study was funded by drug makers.


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