RCT Results: Chlorhexidine vs Povidone-Iodine for Urogyn Surgery
BACKGROUND AND PURPOSE:
Iodine only FDA approved antiseptic agent for vaginal surgery
ACOG gives option of chlorhexidine gluconate or povidone-iodine
Rockefeller et al. (AJOG, 2022) compared the effectiveness of chlorhexidine vs iodine as presurgical vaginal antiseptic solutions for the prevention of urinary tract infection (UTIs) following urogynecologic surgeries
Randomized controlled noninferiority trial
Women undergoing urogynecologic surgery
Patients masked to intervention
All patients received standard antibiotic prophylaxis
Sample size calculation: 58 participants were required per arm to demonstrate noninferiority of chlorhexidine vs iodine
Margin of relative risk of <1.5 for the upper limit of 95% confidence interval
Symptomatic urinary tract infection within 2 weeks after surgery
Culture-proven UTI at 2 and 6 weeks after surgery
Symptomatic UTI at 6 weeks after surgery
Any surgical site infection at 2 weeks after surgery
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This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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