Clinical Report: Comparison of Octenidine and Sterile Water for Cleansing

Overview

This randomized clinical trial evaluates the effectiveness of daily octenidine skin cleansing versus sterile water in reducing late-onset sepsis (LOS) in NICU neonates. The study found no significant difference in the incidence of LOS between the two groups.

Background

Late-onset sepsis is a critical concern in neonatal intensive care units, contributing to significant morbidity and mortality. The incidence of LOS varies widely, particularly affecting vulnerable populations in low- and middle-income countries. Effective infection control measures, such as skin antisepsis, are essential to mitigate this risk.

Data Highlights

No significant difference in LOS incidence was observed between octenidine (14.7%) and sterile water (12.9%) cleansing.

Key Findings

• Octenidine demonstrated faster bactericidal activity compared to chlorhexidine.
• The study included neonates of all gestational ages admitted within 48 hours of birth.
• Randomization was performed using computer-generated permuted blocks.
• Outcome assessors were blinded to minimize detection bias.
• Both interventions resulted in low rates of mild skin reactions.

Clinical Implications

The findings indicate that daily cleansing with octenidine does not significantly reduce the incidence of LOS compared to sterile water.

Conclusion

The trial indicates that octenidine does not provide a clinical advantage over sterile water in preventing late-onset sepsis in neonates.

Related Resources & Content

1. JAMA Network Open, 2023 -- Antiseptic Cleansing to Reduce Vertical Transmission of Pathogens to Neonates: The NeoVT-AMR Randomized
2. Intensive Care Medicine, 2024 -- Impact of Daily Octenidine Antiseptic Bathing on Bacteremia and Multidrug-Resistant Organisms in ICU Settings
3. Infection, 2016 -- Comparative Analysis of Two Antiseptic Protocols on Skin Colonization at Catheter Insertion Sites: Results from a Randomized Clinical Study
4. CDC -- Summary of Recommendations | Infection Control
5. JAMA Network Open, 2023 -- Octenidine or Sterile Water Cleansing and Late-Onset Sepsis in Neonates in the NICU: A Randomized Clinical Trial
6. BJS (British Journal of Surgery) — Comparative Effectiveness of Aqueous Olanexidine Versus Alcohol-Based Chlorhexidine for Surgical Skin Antisepsis in Reducing Surgical-Site Infections: A Randomized Superiority Study
7. Summary of Recommendations | Infection Control | CDC
8. Octenidine or Sterile Water Cleansing and Late-Onset Sepsis in Neonates in the NICU: A Randomized Clinical Trial | Pediatrics | JAMA Network Open | JAMA Network
9. "Pre-procedural Topical Antisepsis in the Neonate: A Systematic Review " by Carly Mulinda, Sana Suhail et al.