HEXACHLOROPHENE AND THE CONTROL OF STAPHYLOCOCCAL SEPSIS IN A MATERNITY UNIT IN GEELONG, AUSTRALIA

Abstract

This paper reports the occurrence and control of staphylococcal sepsis in 35,684 infants born in a maternity unit in Geelong, Australia, during the years 1956 to 1972. Antiseptic skin care of newborn infants with 3% hexachlorophene emulsions (pHisoHex) commenced in 1960 and since then 25,038 infants have been drywashed with 3% hexachlorophene emulsions on alternate days while in hospital with no toxic reactions. A retrospective review of the macroscopic and microscopic findings in 233 neonatal and post neonatal deaths occurring in these 25,038 infants did not reveal any evidence of central nervous system damage as described due to hexachiorophene in animals. A "double-blind" study of 10,001 infants showed that hexachiorophene was the effective agent responsible for the marked reduction in infant and maternal staphylococcal sepsis which occurred in this maternity unit following the introduction of drywashing in 1960. No increase in clinical infection due to gram-negative bacilli is reported since the commencement of drywashing newborn infants with 3% hexachlorophene emulsions. Infant plasma hexachlorophene concentrations on the day prior to discharge home from hospital varied from 0.020 µg/ml to a maximum of 0.l50 µg/ml. The Australian Drug Evaluation Committee accepted a strong recommendation from the author in March, 1971, that antiseptic skin care of newborn infants with 3% hexachlorophene emulsions should continue in maternity hospitals in Australia.