Bibliographic information
GuidelineGuidelines for the prevention of bloodstream infections and other infections associated with the use of intravascular catheters: part 2: central venous catheters
Year of Publication2026
Issuing InstitutionWorld Health Organization
Recommendation
New
WHO suggests using a chlorhexidine containing body wash (liquid or impregnated wipes) daily in critically-ill adults, adolescents and children. (Short- and long-term catheters)
Recommended in favor
Conditional
Certainty of evidence
Low
Notes and Remarks
- The evidence did not differentiate between liquid and impregnated wipes and evaluated chlorhexidine concentrations ranging from 2% to 4%. It was noted that most of the studies provided evidence on the use of chlorhexidine, hence a decision was made to restrict the recommendation to chlorhexidine only and to adults, adolescents and children, but not neonates (due to the risk of chemical burns) (32).
- The GDG noted that the use of this intervention would be particularly beneficial in settings with high baseline central line-associated bloodstream infection (CLABSI) rates. However, the GDG highlighted the need to prioritize resources at the local level based on other competing needs in the health care facility. The GDG also expressed concerns on the potential development of resistance to chlorhexidine and on waste generation when using wipes.
- Chlorhexidine products should be used with caution in patients with burns and according to the manufacturer’s instructions in order to ensure they are safe for use .
- The recommendation refers to using a chlorhexidine-containing body wash (liquid or impregnated wipes) daily and not immediately prior to line insertion. The GDG acknowledges that there are variations in the available protocols on body washing and directs health and care workers to follow their national and local policies.
- The recommendation refers to all critically-ill patients that require a CVC and not limited to the ICU.
- It is advisable to engage nursing and support staff as key stakeholders in the decision (that is, time required for bathing).
- It is also advisable to engage patients and their families, considering the potential adverse effects on the skin related to exposure to chlorhexidine, including asking for any known intolerance and rare allergic reactions to chlorhexidine.
- WASH services and standards (64, 65) are essential to enable critical IPC practices, including this recommendation on body wash.