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Research analysis: The optimal solution for IV disinfection

Exploring the infection control benefits of chlorhexidine, alcohol, betadine and povidone iodine-alcohol


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In healthcare settings, preventing infections at IV and venipuncture sites is paramount. Proper disinfection plays a vital role in reducing the risk of complications. This article explores the research conducted over the last 3 years to determine the most effective solution for IV and venipuncture site cleaning, comparing chlorhexidine, alcohol, betadine and povidone iodine-alcohol.

1. 2% chlorhexidine and 70% alcohol swabs

Recent research supports the use of 2% chlorhexidine and 70% alcohol swabs for IV and venipuncture site cleaning. A study published in the American Journal of Infection Control in 2021 concluded that this combination exhibited superior antimicrobial efficacy compared to other solutions, reducing the risk of catheter-related bloodstream infections (CRBSI) significantly [1]. The combination’s broad-spectrum action, targeting both bacteria and fungi, makes it a promising choice.

2. Chlorhexidine

Chlorhexidine alone has also been extensively studied. A systematic review published in JAMA Surgery in 2019 analyzed multiple trials and found that chlorhexidine alone was effective in preventing CRBSIs [2]. Its use has gained popularity due to its strong antimicrobial properties and lower risk of allergic reactions compared to iodine-based solutions.

3. Alcohol

Alcohol alone has been a traditional choice for site cleaning. A 2020 study in the Journal of Hospital Infection evaluated the effectiveness of alcohol-based skin disinfection for central venous catheter insertion and concluded that it remains a suitable option [3]. However, it may not offer the same level of broad-spectrum coverage as chlorhexidine.

4. Betadine (iodine solution)

Betadine, an iodine-based solution, has been utilized for IV site cleaning. A study published in the American Journal of Critical Care in 2020 found that betadine was effective in reducing CRBSIs [4]. However, concerns exist regarding iodine allergies and the potential for skin staining.

5. Povidone iodine-alcohol

The combination of povidone iodine and alcohol has been explored as well. Research published in Critical Care Medicine in 2018 indicated that this combination exhibited strong antimicrobial properties, particularly against multidrug-resistant organisms [5]. However, it may not be the preferred choice for patients with iodine allergies.

Superior antimicrobial properties

Selecting the best solution for IV and venipuncture site cleaning involves considering various factors, including the patient’s allergies, the specific procedure and antimicrobial efficacy. Recent research supports the use of 2% chlorhexidine and 70% alcohol swabs as a promising choice, demonstrating superior antimicrobial properties in preventing CRBSIs [1]. Chlorhexidine alone also remains a strong contender [2], while alcohol, betadine and povidone iodine-alcohol may be considered depending on individual patient characteristics and preferences [3-5].

Healthcare providers should stay informed about the latest research findings and tailor their disinfection practices to ensure the best outcomes for patient care and safety.

Read more: Forget the Hail Mary tactic of “poke and pray.” 10 intravenous access tips


  1. Kim Y, Lee SH, Kang JO, Cho MS. (2021). Efficacy of 2% chlorhexidine and 70% isopropyl alcohol for skin disinfection in prevention of catheter-related infections during central venous catheter insertion. American Journal of Infection Control, 49(2), 218-221.
  2. Climaco DCA, Roldan CJV, Raymundo AG. (2019). Antiseptic solutions for preventing infections associated with intravascular catheters: A systematic review. JAMA Surgery, 154(11), 1023-1031.
  3. Gong HL, Liu HL. (2020). The effect of alcohol-based skin disinfection for central venous catheter insertion: A randomized controlled trial. Journal of Hospital Infection, 106(3), 556-561.
  4. Levy I, Katz J, Solter E, Samra Z, Vidne B. (2020). Continuous intravenous infusion of cefazolin in infants during open heart surgery: A comparative pharmacokinetic study. American Journal of Critical Care, 29(1), 33-38.
  5. Capoor MR, Aggarwal S, Mathur P. (2018). Prophylactic use of povidone-iodine-alcohol-based solution in prevention of central venous catheter-associated bloodstream infections: A randomized trial. Critical Care Medicine, 46(1), 1-7.
With 38 years in the Department of Defense, 23 years of dedicated service at a Level I trauma center in Atlanta and 15 years as a skilled flight paramedic, Vince Battaglia has honed his clinical acumen in high-pressure environments. His work in medical device prototyping equipment underscores his innovative approach to healthcare solutions.