부산대학교 도서관

Aim: The advantages of polyhexanide in clinical practice are mainly described in relation to its broad antibacterial spectrum, high cell and tissue tolerability, and wound healing-encouraging impact. Some experimental studies tested the efficacy of polyhexanide in preventing infections (i.e., bloodstream infections). Still, no meta-analysis has been performed thus far. Concerning infections in patients who underwent surgical procedures, this study aimed at determining the relative risk difference (RR) with its 95% confidence interval (95%CI) between polyhexanide and controls, summarizing evidence using a systematic review. Method: A systematic review with meta-analysis (random-effect models) was performed in PubMed, Web of Science, Scopus, Embase, and CINAHL, including randomized controlled trials (RCTs) up to November 2022. The "population, intervention, comparison, outcome, study design" (PICOS) guided the search. Results / Discussion: Ten RCTs were included (patients involved=2,330), and 12 comparisons (Polihexanide vs. controls) were feasible for pooling the infection rates into RR. In the control groups, there was a 4% increased risk of having an infection (RR=0.04; 95%CI=0.01-0.08; I2=40.65%) (Figure 1). When a saline solution was used in the control group, there was a nonsignificant trend towards an increased risk of infections (RR=0.013; 95%CI=-0.01--0.026; I2=48.65%) (Figure 2). No substantial decreased risk differences emerged in using polyhexanide for application, irrigation, or dressings (Figure 3). The likelihood of publication bias is small (Figure 4), and the overall quality of evidence ranges from moderate to poor. Conclusion: There is evidence that Polihexanide is effective in reducing infection rates compared to active (e.g., Chlorhexidine, Povidone-iodine) and non-active (e.g., saline solution) controls. Future well-designed and real-world trials are required to determine in which setting and population Polihexanide is more effective.