EBM Consult

Chlorhexidine (Chloraprep) vs. Povidone-iodine (Betadine) for Preventing Post Procedure & Surgical Wound Infections


  • It appears from several studies, meta-analysis, and use across several different indications, that topical chlorhexidine-gluconate-70% isopropyl alcohol solution applied to the skin is more effective than povidone-iodine (Betadine) at preventing skin or wound infections when used prior to an invasive or surgical procedure.
  • This beneficial effects of chlorhexidine over povidone-iodine (Betadine) may have to do with chlorhexidine's rapid onset of action and continued efficacy despite the skin being exposed to bodily fluids that could deactivate iodine containing topical antiseptic agents.


  • Anthony J. Busti, MD, PharmD, MSc, FNLA, FAHA
  • Dylan Kellogg, MD

Landmark or Original Studies

  • Darouiche RO et al. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N Engl J Med 2010;362(1):18-26. PubMed

Supporting Studies

  • Noorani A et al. Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean-contaminated surgery. Br J Surg 2010;97(11):1614-20. PubMed

Related Articles & Reviews

  • Chaiyakunapruk N et al. Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: a meta analysis. Ann Intern Med 2002;136(11):792-801. PubMed

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