Chlorhexidine or Chlorhexidine Gluconate, is one of the
most widely used antiseptics for oral rinses or mouthwashes to reduce dental
plaque and oral bacteria. It is also used for skin cleaners for surgical scrubs
and preoperative skin preparations.
Chlorhexidine is a broad-spectrum antiseptic that is
considered to have rapid action, residual activity and is active in the
presence of organic matter. The positive charge carried by the chlorhexidine
molecule reacts with the cell surface of bacteria which is negatively charged
and destroys the cell membrane. It is effective on both gram-positive and
gram-negative bacteria, although it is less effective with some gram-negative
bacteria. It has also shown to have some virucidal efficacy and to inhibit
spores and fungi. Depending on the level
of kill (e.g. sanitizing vs. disinfection), Chlorhexidine is effective in
contact times of 30-seconds to 2 minutes against vegetative bacteria.
considered to have rapid action, residual activity and is active in the
presence of organic matter. The positive charge carried by the chlorhexidine
molecule reacts with the cell surface of bacteria which is negatively charged
and destroys the cell membrane. It is effective on both gram-positive and
gram-negative bacteria, although it is less effective with some gram-negative
bacteria. It has also shown to have some virucidal efficacy and to inhibit
spores and fungi. Depending on the level
of kill (e.g. sanitizing vs. disinfection), Chlorhexidine is effective in
contact times of 30-seconds to 2 minutes against vegetative bacteria.
Chlorhexidine is non-flammable. At high concentrations Chlorhexidine is
harmful, however at the low concentrations typically used for oral rinses and
skin cleaners it can be safely used. Despite Chlorhexidine being relatively non-toxic at low concentrations,
there have been incidences of anaphylactic reactions. In fact, in the UK, a patient safety alert
on the risk of anaphylactic reactions from the use of medical devices and
medicinal products containing chlorhexidine has been issued with
recommendations that if a patient experienced an unexplained reaction that
healthcare providers check whether chlorhexidine was used or was impregnated in
a medical device that was used.
harmful, however at the low concentrations typically used for oral rinses and
skin cleaners it can be safely used. Despite Chlorhexidine being relatively non-toxic at low concentrations,
there have been incidences of anaphylactic reactions. In fact, in the UK, a patient safety alert
on the risk of anaphylactic reactions from the use of medical devices and
medicinal products containing chlorhexidine has been issued with
recommendations that if a patient experienced an unexplained reaction that
healthcare providers check whether chlorhexidine was used or was impregnated in
a medical device that was used.
From an environmental perspective, the by-products that
chlorhexidine degrades into are reported to be more toxic that chlorhexidine
itself. Further, chlorhexidine can
accumulate in the bodies of aquatic creatures and thus increases the toxic
effects caused by long-term exposure.
chlorhexidine degrades into are reported to be more toxic that chlorhexidine
itself. Further, chlorhexidine can
accumulate in the bodies of aquatic creatures and thus increases the toxic
effects caused by long-term exposure.
Here’s how we would score Chlorhexidine on the key
decision making criteria:
decision making criteria:
• Speed of Disinfection – A to B
o Contact times will be dependent upon concentration and
level of kill required and range from 30 seconds to 2 minutes
level of kill required and range from 30 seconds to 2 minutes
• Spectrum of Kill – B to C
o Achieves disinfection against all microorganisms;
bacteria, viruses and fungi but efficacy is concentration dependent
bacteria, viruses and fungi but efficacy is concentration dependent
• Cleaning Effectiveness – C
o Some cleaning studies have shown that Chlorhexidine is
not an effective cleaning agent
not an effective cleaning agent
• Safety Profile – B
o Is considered safe to humans at the concentrations used
for oral rinses and skin cleaners
for oral rinses and skin cleaners
o Anaphylactic reactions are well documented
• Environmental Profile – D
o Bioaccumulative in the environment and reacts to form more toxic by-products
o Concerns with Aquatic Toxicity
• Cost Effectiveness – B to C
o Products are available from a number of suppliers
**For more in-depth scientific information about Alcohol
and other disinfectant chemistries, stay tuned to
www.infectionpreventionresource.com.
and other disinfectant chemistries, stay tuned to
www.infectionpreventionresource.com.
Bugging off!
Nicole
