Chlorhexidine

Chlorhexidine Brand Names

Betasept | Chlorostat | Hibiclens | Oro Clense | Peridex | PerioChip | Periogard | PerioRx | Perisol

What is Chlorhexidine

Chlorhexidine gluconate is a topical antimicrobial agent.

It is used as an oral rinse for the treatment of gingivitis and periodontitis and topically as a surgical scrub, health-care personnel hand wash, patient preoperative skin preparation, skin wound cleanser, general skin cleanser and for the treatment of acne vulgaris.

It is also available as a 2% cloth and as a swab with 3.15% chlorhexidine gluconate and 70% isopropyl alcohol; both are indicated for use as a preoperative skin preparation.

Other uses of chlorhexidine include prophylaxis and treatment of mouth infections, treatment of denture stomatitis, ulcerative stomatitis, and acute necrotizing ulcerative gingivitis (ANUG).

Chlorhexidine oral rinse is commonly used to prevent and treat mucositis in patients receiving chemotherapy.

Chlorhexidine is also incorporated into several types of medical devices including intravenous catheters, topical antimicrobial skin dressings and implantable dental chips and surgical mesh.

Chlorhexidine dental implant is indicated as an adjunct to scaling and root planing procedures in adults with periodontitis.

Chlorhexidine’s bacterial spectrum includes both gram-positive and gram-negative bacteria, some viruses including HIV, and fungi; but is sporicidal only at elevated temperatures.

In several studies, chlorhexidine has shown a greater decrease in initial bacterial counts of hands and a greater reduction in residual bacterial flora with continued use when compared to povidone-iodine 0.75%, hexachlorophene 3% emulsion, iodophor and alcohol containing foam.

Chlorhexidine is an ideal topical antiseptic due to its persistent activity on the skin with continued use, rapid and broad bactericidal activity, and minimal absorption, although severe allergic reactions have been associated with the topical antiseptics and medical devices containing chlorhexidine.

Indications

  1. acne vulgaris
  2. Bacteroides forsythus
  3. Campylobacter rectus
  4. denture stomatitis
  5. gingivitis
  6. periodontitis
  7. Porphyromonas gingivalis
  8. Prevotella intermedia
  9. Propionibacterium acnes
  10. skin antisepsis
  11. stomatitis

Side Effects

  1. anaphylactic shock
  2. anaphylactoid reactions
  3. angioedema
  4. arthralgia
  5. back pain
  6. calculus (tartar) formation
  7. cough
  8. dental pain
  9. dyspepsia
  10. dyspnea
  11. edema
  12. erythema
  13. gingival hyperplasia
  14. gingivitis
  15. glossitis
  16. headache
  17. hypertension
  18. hypoesthesia
  19. infection
  20. influenza
  21. metallic taste
  22. myalgia
  23. oral ulceration
  24. paresthesias
  25. parotitis
  26. pharyngitis
  27. rash
  28. rhinitis
  29. sinusitis
  30. skin irritation
  31. stomatitis
  32. tooth discoloration
  33. urticaria
  34. wheezing
  35. xerostomia

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • breast-feeding
  • children
  • dental work
  • infants
  • infection
  • lumbar puncture
  • neonates
  • occlusive dressing
  • ocular exposure
  • periodontal disease
  • pregnancy
  • serious hypersensitivity reactions or anaphylaxis
  • skin disease
  • surgery
  • tobacco smoking
  • tympanic membrane perforation

Drug Interactions

  • Disulfiram

Disulfiram: (Minor) Some chlorhexidine oral rinses contain ethanol in significant percentages.

Although chlorhexidine is poorly absorbed from the GI tract and the products are intended for oral topical rinse and not for systemic ingestion, there is a potential for interaction with disulfiram when such products are swallowed.

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