Low-Cost Antiseptic Regimen Reduces Bacteria Linked to Newborn Infections

Neonatal sepsis causes a high burden of mortality in low-income countries, with bacteria often transferred from mother to baby during birth. Preventing early bacterial exposure at delivery is therefore a priority for maternity and neonatal services. Strategies must be simple, safe, and affordable to scale in resource-limited hospitals. To help address this challenge, a new study has evaluated targeted antiseptic cleansing for women in labor and for newborns shortly after birth.

The approach centers on chlorhexidine-based cleansing of the maternal genital tract during labor and cleansing of newborn skin immediately after delivery. The work was led by scientists at City St George’s and is published in JAMA Network Open on June 11, 2026. The evaluation examined whether routine, low-cost antiseptics could reduce bacterial load linked with early-onset infection risk.

In the NeoVT-AMR clinical trial at Zomba Central Hospital in Malawi, 149 women in labor and 147 newborns were randomly allocated to receive one of several regimens. Groups included 1% chlorhexidine, 2% chlorhexidine, an alternative antiseptic comprising octenidine with phenoxyethanol, or standard care that involved sterile water for mothers and no cleansing for newborns. This design enabled head-to-head assessment of concentration effects and comparison with existing practice.

Antiseptics were applied to mothers either once or every four hours and to newborns either once or every 24 hours. Investigators measured changes in bacterial levels in the maternal genital tract and on newborn skin as indicators of infection risk. Safety and feasibility were assessed in routine clinical conditions, with mother–infant follow-up through day 28.

A single application of 1% chlorhexidine reduced bacterial load by about 3,000-fold in women during labor compared with standard care, and by about 16-fold in newborns. There was no evidence that 2% chlorhexidine provided additional benefit, and the octenidine–phenoxyethanol combination was less effective. The 1% chlorhexidine regimen showed no increase in serious adverse events and no evidence of harm, including skin irritation or neonatal hypothermia.

The findings highlight a practical option that aligns with infection prevention in low- and middle-income countries. Because chlorhexidine is inexpensive and already widely used, the regimen could be incorporated into hospital protocols pending larger trials that evaluate effects on clinical infection outcomes.

“Newborn infections remain a leading cause of death globally. We’ve shown that this simple, low-cost intervention can safely reduce the levels of bacteria present during or at birth, potentially lowering the risk of serious yet avoidable infections. Our findings support 1% chlorhexidine as the best antiseptic to take forward into larger trials designed to determine whether this approach can reduce life-threatening infections in newborns and save lives,” said Dr. Emily Beales, lead author of the study from the School of Health & Medical Sciences.

“The use of 1% chlorhexidine is likely to be most effective as part of a broader package of infection control measures, helping to tackle both maternal and neonatal infections. With further research, this approach could contribute to reducing the global burden of neonatal sepsis and improving survival outcomes for some of the world’s most vulnerable patients,” added Beales.

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City St George’s, University of London