OBJECTIVES: Catheter-related bloodstream infection (CRBSI) is a frequent (1-5/1000 catheter-days) and life-threatening complication in intensive care unit (ICU), preventable by systematic use of a new antimicrobial transparent dressing containing a chlorhexidine gluconate (CHG) hydrogel (60% risk reduction in a recent RCT). Our purpose is to evaluate the advantages of routine use of the new CHG-dressing to secure central lines of patients in ICU from the medico-economic viewpoint compared to non-antimicrobial (reference). Both medical and economic criteria are embedded into an analytic decision model to support the choice of the best dressing strategy. METHODS: A 30-day ICU-time non-homogeneous markovian model comprises eight states: five combining either occurrence or no-occurrence of: CRBSI, contact dermatitis, and the need of a new central line; one for changing alternative dressing in case of dermatitis and two absorbent states (death and discharge). The probabilities of events derive a multicentre RCT on 1,879 patients. Monte Carlo simulations of 1,000 patients are used for probabilistic sensitivity analysis and 95% confidence intervals (CI) calculations. The final health outcome is the number of CRBSI averted. Costs of ICU stay are updated from estimations of a French study from 2010. This economic evaluation takes into account ICU perspective in France. RESULTS: The CHG-dressing prevents 11.75 infections (95% CI: [-19.64; -3.85], number needed to treat=85) for 1,000 patients as estimated via probabilistic cost-effectiveness sensitivity analysis. The mean adjusted cost per patient is €2013 21,391 [95% CI: €20,339; €22,443] for the CHG-dressing group and €2013 20,882 [95% CI: €19,905; €21,859] for the reference dressing. CONCLUSIONS: The CHG-dressing, significantly more efficacious to prevent CRBSI when compared to the reference dressing, contributes to preserve patients’ health capital at the same cost for the ICU. According to the base case scenario the CHG-dressing is more cost-effective than the reference dressing.