Microbiological efficacy and skin tolerance of commonly used nonantiseptic inpatient bathing practices in non-ICU settings: A systematic review

Published:October 01, 2020DOI:


      • Patient bathing with nonantiseptic products was not found to reduce health care-associated infections.
      • Patient bathing with nonantiseptic products does not reduce skin colonization.
      • No-rinse washcloths may be preferable in bed-bound patients to decrease skin lesions.
      • Showers may reduce C difficile skin contamination more effectively than baths.



      Nonantiseptic bathing practices among inpatients and residents of nursing homes vary in terms of frequency, bathing type and product. We performed a systematic review to compare the efficacy of different bathing practices in reducing skin colonization, health care-associated infections (HAI) or their impact on skin integrity.


      We searched Medline and Embase up until February 2018 testing a combination of terms for 3 concepts: (1) personal hygiene, (2) inpatients, (3) skin colonization, integrity or HAIs. Studies set in ICUs or including children were excluded. This review was registered in PROSPERO: CRD42018091639.


      Seven studies were included. No statistically significant impact in terms of reduced skin colonization was described irrespective of bathing product, type or frequency except for a reduced burden of C difficile on the skin of infected patients after showering compared to bathing. One study addressing impact on HAI did not detect a significant difference when a waterless no-rinse product was used. Integrity of the skin was better preserved by no-rinse products.


      No study described a statistically significant reduction of bacterial skin colonization or incidence of HAI after bathing hospitalized patients with nonantiseptic products. However, waterless no-rinse products were associated with less skin damage in most studies.

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