Long-term care facilities that used a decolonization routine using chlorhexidine cleansing and nasal povidone-iodine reduced transfers to hospitals due to infections and other causes, according to a new study in the New England Journal of Medicine.  

The study, published in early November, reveals facilities that use this regimen can prevent infections and lower the number of antibiotic-resistant organisms. Researchers examined approximately 14,000 residents and compared bathing routines at 28 nursing homes in California. Fourteen facilities used regular cleaning methods, and the others decolonized all residents with chlorhexidine and a nasal swab containing povidone-iodine (iodophor) to remove pathogens from residents’ skin and noses. This soap and swab technique has been used in healthcare for more than 60 years.

In those who received the chlorhexidine/povidone-iodine intervention, the prevalence of multidrug-resistant organisms was cut in half. 

The authors concluded that universal decolonization with chlorhexidine and nasal povidone-iodine led to a significantly lower risk of transfer to a hospital due to infection than routine care.

For every 12.5 people in nursing homes who receive this decolonization intervention, one hospitalization (for any reason) will be prevented, researchers said. And for every 10 residents receiving this intervention, one infection-related hospitalization could be prevented. 

“For an older person, having an infection and needing to be transferred to the hospital can be life-threatening. Now, nursing homes have another tool to help them prevent infections, reduce transfers, and keep our older adults safe,” Robert Otto Valdez, PhD, director of the Agency for Healthcare Research and Quality, said in a statement. The AHRQ funded the study.