Cetrimide 0.15% / Chlorhexidine gluconate 0.015% irrigation solution 500ml bottles

Background: Endometritis, maternal fever and wound infection represent the most frequent post-cesarean complications. The aim of the present research was to evaluate the incidence of post-cesarean infections after vaginal cleansing. Materials and methods: The databases analyzed were MEDLINE, Scopus, EMBASE, CENTRAL, Google Scholar, Clinicaltrials.gov and the Register of Controlled Trials. No language or geographical restrictions were applied. We included only randomized controlled trials that analyzed various vaginal antiseptic solutions to reduce postpartum endometritis. The terms employed were as follows: vaginal solution, cesarean section, endometritis, wound infection, chlorhexidine, povidone, metronidazole, cetrimide, and pregnancy. The PICO categorization was as follows: P—population: pregnant women; I—intervention: vaginal antiseptic; C—control: hands-off or routine care; O—outcome: post-cesarean endometritis, wound infection and postoperative fever; S—study design: randomized controlled trials. Results: A total of 32 articles, including 13,853 participants, were selected. The vaginal cleansing group showed a low incidence of endometritis. The chlorhexidine group had an OR of 0.56 (95% CI 0.45–0.70, p = 0.010). The povidone group had an OR of 0.47 (95% CI 0.37–0.59, p = 0.002). Considering maternal fever, 2598 patients from 5 studies in the chlorhexidine group were analyzed, alongside 6965 patients from 18 trials in the povidone group. The povidone group presented an Odds ratio of 0.47 (95% CI 0.38–0.57, p = 0.0001). A reduction in wound infection incidence was observed in the povidone group (OR = 0.59, 95% CI = 0.42–0.82, p < 0.05). Conclusions: Vaginal cleansing before cesarean section, particularly with povidone solutions, reduces the incidence of postoperative endometritis and maternal fever.

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This systematic review aims to compare the efficacy of sodium hypochlorite (NaOCl) and chlorhexidine digluconate (CHX) in decontaminating gutta-percha (GP) cones against endodontic pathogens-Enterococcus faecalis (E. faecalis), Staphylococcus aureus (S. aureus), and Candida albicans (C. albicans)-within 0-10 min. A systematic search was conducted in six databases (PubMed, Web of Science, Cochrane Library, SCIELO, Scopus, and LILACS), supplemented by manual searches performed independently by three reviewers. No publication year restrictions were applied, and only English-language studies were included. This review followed the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The risk of bias was assessed using six parameters with a modified Cochrane risk of bias tool. Out of 309 potentially eligible studies, 216 were screened by title and abstract, 32 were selected for full-text assessments, and 7 were included. All studies had a moderate or high risk of bias. The majority of the included studies showed that higher NaOCl concentrations effectively eliminate E. faecalis and S. aureus within 1-5 min. However, data on CHX's antimicrobial effect on C. albicans were limited. The qualitative analysis suggests that NaOCl remains the most effective agent for GP decontamination, while CHX with additives shows potential against fungal species.

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ImportanceIntravascular catheters are essential in health care but remain a major source of health care-associated infections. Optimal skin antisepsis before insertion is key, yet the most effective antiseptic agent, concentration, and formulation remain uncertain.ObjectiveTo determine the concentration and formulation of chlorhexidine gluconate (CHG) or povidone-iodine (PVI) associated with the lowest incidence of catheter-related infections (CRIs).Data sourcesPubMed, EMBASE, Cochrane Central, Scopus, Web of Science, and CINAHL were searched through January 7, 2025, without restrictions. Trial registries and reference lists of relevant studies and guidelines were reviewed.Study selectionRandomized clinical trials (RCTs) comparing CHG- or PVI-based skin antisepsis before insertion of intravascular catheters were eligible if they reported at least 1 CRI outcome (catheter-related bloodstream infection [CRBSI], catheter tip colonization, or local infection). Two independent reviewers screened titles, abstracts, and full texts.Data extraction and synthesisData were extracted independently by 2 reviewers following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed with the Cochrane risk of bias 2 tool. A random-effects network meta-analysis (NMA) was performed to estimate relative risks (RRs) with 95% CIs.Main outcomes and measuresThe primary outcomes were incidence of CRBSIs, catheter tip colonization, and local infections associated with CHG or PVI formulations.ResultsSixteen RCTs (7803 patients; 11 985 catheters) met inclusion criteria. When compared with aqueous formulations, alcohol-based formulations were consistently associated with lower infections rates, with isopropyl alcohol being superior to ethanol. Compared with alcoholic PVI, alcoholic CHG was associated with lower CRBSIs (RR, 0.70 [95% CI, 0.45 to 1.08]), catheter tip colonizations (RR, 0.42 [95% CI, 0.37 to 0.48]), and local infections (RR, 0.40 [95% CI, 0.23 to 0.70]). High concentration CHG (1% or higher) further lowered CRBSIs (RR, 0.31 [95% CI, 0.19 to 0.52]) and colonization (RR, 0.36 [95% CI, 0.30 to 0.42]) compared with lower concentrations. Local adverse events were uncommon, slightly more frequent with alcohol-based formulations, and similar between CHG and PVI.Conclusions and relevanceIn this NMA of RCTs, high concentration CHG in isopropyl alcohol was associated with the lowest incidence of CRIs. These results suggest that alcoholic PVI and aqueous formulations should be reserved for situations in which CHG or alcohol cannot be used.

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AimTo evaluate the most effective chemotherapeutic agent for decontamination of infected dental implants.Material and methodsA systematic electronic literature search in MEDLINE (PubMed) and Google scholar between January 2010 to December 2021 was carried out by using the PRISMA guidelines. A total of five studies related to chemical decontamination of the dental implant were evaluated. The search strategy was based on the PICOS framework. Randomized controlled trials (RCT's) and cohort studies evaluating the effectiveness of different chemotherapeutic agents for the decontamination of dental implants were included in the study. The outcome variable examined was the most effective chemotherapeutic agent(s) for dental implant surface decontamination after comparing the chemotherapeutic agents used in the qualifying studies.ResultOut of the basic database of 1564 records, 1380 articles were excluded due to irrelevance, unavailability, and repetition. Furthermore, 134 articles were excluded from 184 studies for various reasons. After further filtration, 13 studies were shortlisted. Two investigators (SSA and SA) appraised the quality of the selected studies using the risk of bias assessment tool. After excluding eight studies, five articles were finally included in the present systematic review.ConclusionThe data reported for the efficacy of chemotherapeutic agents in cleaning contaminated titanium surfaces are scarce, thus it is not possible to draw a definite conclusion. However, chlorhexidine (CHX) (0.2%, 0.12%), citric acid (40%) and sodium hypochlorite (1%) are the most commonly used chemotherapeutic agents; amongst them, citric acid showed the highest potential for biofilm removal from the contaminated implant surface. All three agents [CHX (0.2%, 0.12%), citric acid (40%), and sodium hypochlorite (1%)] can be recommended as therapeutic agents along with their curbs.

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