Are high residual chlorhexidine skin concentrations associated with improved clinical outcomes? Lessons from the CLEAR trial.

Residual chlorhexidine gluconate (CHG) skin concentrations are thought to improve disease prevention. In the Changing Lives by Eradicating Antibiotic Resistance (CLEAR) trial, posthospitalization decolonization of MRSA carriers reduced MRSA infection and all-cause infection, but higher residual CHG concentrations did not improve outcomes. CHG concentration may indicate bathing quality, but high residual concentrations may not be necessary for benefit.