Universal Decolonization at Nursing Homes Beneficial

WEDNESDAY, Oct. 18, 2023 (HealthDay News) -- Universal decolonization with chlorhexidine and nasal iodophor in nursing homes leads to a significantly lower risk for transfer to a hospital due to infection, according to a study published online Oct. 10 in the New England Journal of Medicine.

Loren G. Miller, M.D., M.P.H., from the Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center in Torrance, California, and colleagues performed a cluster-randomized trial of universal decolonization versus routine-care bathing in nursing homes, which included an 18-month baseline period and an 18-month intervention period. Decolonization included use of chlorhexidine for all routine bathing and showering and use of nasal povidone-iodine. Data were obtained from 28 nursing homes with 28,956 residents.

The researchers found that during the baseline and intervention periods, 62.2 and 62.6 percent of the transfers to a hospital in the routine-care group were due to infection (risk ratio, 1.00; 95 percent confidence interval, 0.96 to 1.04). In the decolonization group, the corresponding values were 62.9 and 52.2 percent (risk ratio, 0.83; 95 percent confidence interval, 0.79 to 0.88), for a difference of 16.6 percent in the risk ratio compared with routine care. For transfer to a hospital for any reason, the difference in the risk ratio was 14.6 percent for universal decolonization compared with routine care. To prevent one infection-related hospitalization and one hospitalization for any reason, the number needed to treat was 9.7 and 8.9, respectively.

"Our findings suggest that the prevention of serious infection in nursing homes can be facilitated with a relatively simple intervention with a low number needed to treat," the authors write.

Several authors disclosed ties to the medical device industry.

Abstract/Full Text (subscription or payment may be required)