NPPG issues position statement on chlorhexidine for skin cleansing in neonates

The Neonatal and Paediatric Pharmacists Group (NPPG) has announced the publication of its position statement regarding the use of chlorhexidine for skin cleansing in neonates

The position statement should help to provide clarity where there is a known variation in practice and/or where evidence for use is limited. The statement aims to provide a pragmatic approach for the use of chlorhexidine in neonates based on ensuring that the chlorhexidine product will be effective but also safe for extremely premature neonates. The position statement has been endorsed by the British Association of Perinatal Medicine.

NPPG Chair Nigel Gooding says: "We hope this position statement allows organisations to review their practice and provides a consistency in approach when using chlorhexidine in neonates. We welcome pharmaceutical manufacturers developing a licensed preparation of chlorhexidine 0.5% aqueous solution, as only an unlicensed preparation is currently available."

Take home summary:

In babies born before 34 weeks' gestation and who are under seven days old, use aqueous solutions of 0.5% chlorhexidine gluconate for skin preparation.

In babies born from 34 weeks' gestation onwards and for those babies born before 34 weeks' gestation who are now seven days or older, use a solution of 2% chlorhexidine in isopropyl alcohol for skin preparation.

Irrespective of the skin preparation solution used, it is critical to avoid pooling on the skin and surfaces (such as incubator or cot sheets) that may come into contact with the baby's skin. For this reason, the use of an applicator device is recommended wherever possible.