Chlorhexidine Gluconate (CHG) Bathing to Prevent New Infections

Chlorhexidine gluconate (CHG) is a cleaning product that kills germs. Daily baths with CHG are helpful for people in intensive care units (ICUs). They help keep infections from spreading.

Increased risk for infection in the ICU

In the ICU, you have a higher risk of getting a new infection. In the ICU, you are more likely to need treatments, such as central lines, urinary catheters, and ventilators. These things increase the risk of getting a new infection. And many ICUs contain bacteria that may not be killed by standard antibiotics. They can cause infections that are very hard to treat.

How CHG bathing helps

A daily CHG bath is recommended for anyone in the ICU. Bathing with CHG is better at preventing infections than bathing with plain soap and water. Daily CHG bathing lowers your risk of getting an infection in the hospital.  CHG bathing can help prevent infections from germs, such as:

• Methicillin-resistant Staphylococcus aureus (MRSA)

• Vancomycin-resistant Enterococcus (VRE)

• Infections from central venous catheters

• Infections at surgical sites

• Infections from ventilator use

People are at risk of getting a new infection while in the hospital. If you are at high risk for infection, your healthcare provider may advise a daily CHG bath for you, even if you are not in the ICU.

In some cases, you may do CHG bathing at home. For example, your healthcare provider may tell you when to use a CHG skin cleanser before your surgery. This helps reduce the chance for infection. CHG baths may also be used for MRSA skin infections. This is to try to remove MRSA bacteria from your skin and prevent future infections.

CHG bathing is not a substitute for other ways of controlling infection in the hospital. It also can't prevent infection all of the time. But regular CHG bathing may reduce the risk that you will get a new infection. That may shorten your hospital stay and make it more likely for you to get well.

Risks of CHG bathing

CHG bathing is generally safe. Possible side effects may include:

• Skin rash (usually mild)

• Allergic reaction

• Skin dryness

• Irritation of the eyes, mouth, or vagina

• Anaphylactic reaction. This is a rare but serious and sometimes life-threatening allergic reaction.

Your risks may differ, depending on your age, your overall health, and other factors. CHG bathing might not be right for you if you have serious skin problems or conditions, skin irritation, skin that is not intact, or burns. Your healthcare provider will decide if CHG bathing is right for you. Always talk with your healthcare provider about all of your concerns.

During CHG bathing

You may get a CHG bath each day. Methods of CHG bathing may differ from hospital to hospital. Your healthcare team can let you know what to expect. As an example, you might expect the following:

• Your nurse will help you remove your clothes and any medical equipment (such as ECG leads), if possible.

• Your nurse will wash their hands and put on new gloves.

• If this is your first CHG bath, you may get a non-CHG sponge bath first. When you are dry, the CHG bath will begin.

• The nurse may use disposable wipes that already contain CHG. Your nurse will use these wipes to bathe your body from the neck down. 

• Your face is not cleaned with CHG solution. A non-CHG solution is used to clean above the jaw line.

• Based on instructions from your healthcare provider and recommendations from the manufacturer of CHG, certain areas of your body may not be bathed with the solution.

After CHG bathing

After CHG bathing, you will air dry because it's important not to wipe off the CHG after your bath. Your skin may feel sticky for a few minutes but shouldn't be rinsed off with water. When your skin is completely dry, the sticky feeling usually goes away.

Your healthcare provider will decide if you need special lotions or ointments after your CHG bath. Any medical equipment that was taken off before your CHG bath will be put back on. You will put your hospital gown or clothing back on. 

Let your healthcare provider or the hospital staff know right away if the CHG bath feels uncomfortable. Some people may have an allergic reaction to CHG. If that happens, your healthcare provider will decide if you need to stop CHG bathing.