Efficacy of Chlorhexidine Alcohol versus Povidone Iodine Alcohol in Reducing Peripheral Venous Catheter Colonisation in Paediatric Patients: A Randomised Controlled Trial

Introduction: Peripheral Venous Catheters (PVCs) are routinely used in paediatric patients but are associated with catheterrelated infections. Adequate skin antisepsis prior to catheter insertion is critical in preventing these infections.

Aim: To compare the efficacy of 2% chlorhexidine in alcohol (CHA) with 10% povidone-iodine in alcohol (PI) in reducing catheter-tip colonisation in paediatric patients.

Materials and Methods: A double-blind randomised controlled trial was conducted at the Paediatric Ward of Acharya Vinoba Bhave Rural Hospital, Maharashtra, India, from May 2024 to December 2024. A total of 102 paediatric patients aged 1 month to 16 years, admitted to the paediatric ward with an indication for intravenous catheterisation, were randomly assigned to two groups: Group A received 2% CHA and Group B received 10% PI in alcohol before PVC insertion. Upon catheter removal, the distal tips were cultured for microbial colonisation. Parameters assessed included gender, age group, mean age, incidence of catheter-tip colonisation, and type of organism isolated. Statistical tests applied included Chi-square test, Independent t-test, and Fisher’s exact test.

Results: Demographic data showed comparable gender distribution (M:F=31:20 in Group A, 30:21 in Group B) and mean age (6.6±3.05 years vs 7.14±3.42 years) between the two groups. Catheter-tip colonisation occurred in 1 (1.96%) patient in Group A and 6 (11.76%) in Group B (p-value=0.112). Staphylococcus was the predominant organism in both groups, while Klebsiella and Gram-positive Cocci (GPC) were additionally isolated in the PI group.

Conclusion: Catheter-tip colonisation was higher in the PIalcohol group (6/51) compared with the CHA group (1/51); however, this difference did not reach statistical significance (p-value=0.112). A larger study is warranted to provide more definitive evidence.