Efficacy Of Chlorhexidine Gluconate Research Articles

Chlorhexidine gluconate for antisepsis in preterm neonates: A review of safety and efficacy.

Sepsis is a leading cause of death in preterm neonates. The increased susceptibility to sepsis is due to prolonged hospitalization, the need for invasive procedures, and immaturity of innate and adaptive immunity. Chlorhexidine gluconate is a popular topical disinfectant that was not recommended for use in preterm neonates until 2012. Thus, there are few studies assessing the role of chlorhexidine gluconate in antisepsis for preterm neonates. A better understanding of the safety and efficacy of chlorhexidine gluconate as an antiseptic agent for preterm neonates is the first step in establishing best practice guidelines for this population.

Chlorhexidine Wipes to Reduce Multidrug-Resistant Gram-negative Bacterial Colonization and Healthcare-associated Infections among Medical Inpatients: A Cluster-Randomized Trial

Objective: To evaluate efficacy of chlorhexidine gluconate (CHG) to decolonize multidrug-resistant (MDR) gram-negative bacilli (GNB) bacteria, and to reduce healthcare associated infections (HAIs) in general medical inpatients. Materials and Methods: A 1-year, cluster-randomized study was conducted in a university hospital-based general medical unit. Eligible patients were randomized by study ward for routine daily and extra wiping with non-rinsed CHG-cloths (CHG group, n=145) or rinsed, non-medicated soap bath (control group, n=145), consecutively to the end of study. Study nurses received training and audits per CHG protocol. In all participants, axillae, groins, and perianal area were sampled to detect GNB colonization, on day 4 to 7 and day 11 to 14 of admission, by surveillance culture. All were followed for incidence rates of HAIs to day 14 of the study, or study exclusion. Results: MDR GNB colonization were significantly lower in CHG group than those of control group, both day 4 to 7 (15.9% versus 43.4%, respectively, p<0.01), and day 11 to 14 of admission (20.6% versus 65.4%, respectively, p<0.01). The incidence rates of overall HAIs did not differ between groups (5.80 versus 7.10 episodes per 1,000 patient-day, respectively, p=0.84). Three patients developed minor skin irritation in CHG group. Discussion: To the investigators’ knowledge, the present study is the first to demonstrate significant CHG reduction of MDR GNB colonization among medical patients in non-critical care unit. Use of non-rinsed CHG bath, personnel training, and audits, may maintain adequate skin concentration of CHG, and lower risk of cross-transmission. To effectively reduce HAIs, combined CHG bath and bundle of care may be required. Conclusion: Non-rinsed chlorhexidine baths are safe, well-tolerated, and effective to reduce MDR gram-negative bacterial colonization among general medical inpatients, and possible to lower risk of subsequent HAIs and cross-transmission, by day 14 of admission. Keywords: Multidrug-resistant gram-negative bacilli, Chlorhexidine bath, Decolonization, Healthcare associated infections, General medical inpatients

Repeated delivery of chlorhexidine chips for the treatment of peri‐implantitis: A multicenter, randomized, comparative clinical trial

Peri-implantitis is a challenging condition to manage and is frequently treated using non-surgical debridement. The local delivery of antimicrobial agents has demonstrated benefit in mild to moderate cases of peri-implantitis. This study compared the safety and efficacy of chlorhexidine gluconate 2.5mg chip (CHX chips) as an adjunctive treatment to subgingival debridement in patients afflicted with peri-implantitis. A multicenter, randomized, single-blind, two-arm, parallel Phase-3 study was conducted. Peri-implantitis patients with implant pocket depths (IPD) of 5-8mm underwent subgingival implant surface debridement followed by repeated bi-weekly supragingival plaque removal and chlorhexidine chips application (ChxC group) for 12weeks, or similar therapy but without application of ChxC (control group). All patients were followed for 24weeks. Plaque and gingival indices were measured at every visit whereas IPD, recession, and bleeding on probing were assessed at 8, 12, 16, 24week. A total of 290 patients were included: 146 in the ChxC group and 144 in the control. At 24weeks, a significant reduction in IPD (P=0.01) was measured in the ChxC group (1.76 ± 1.13mm) compared with the control group (1.54 ± 1.13mm). IPD reduction of ≥2mm was found in 59% and 47.2% of the implants in the ChxC and control groups, respectively (P=0.03). Changes in gingival recession (0.29 ± 0.68mm versus 0.15 ± 0.55mm, P=0.015) and relative attachment gain (1.47 ± 1.32mm and 1.39 ± 1.27mm, P=0.0017) were significantly larger in the ChxC group. Patients in the ChxC group that were<65 years exhibited significantly better responses (P<0.02); likewise, non-smokers had similarly better response (P<0.02). Both protocols were well tolerated, and no severe treatment-related adverse events were recorded throughout the study. Patients with peri-implantitis that were treated with an intensive treatment protocol of bi-weekly supragingival plaque removal and local application of chlorhexidine chips had greater mean IPD reduction and greater percentile of sites with IPD reduction of ≥2mm as compared with bi-weekly supra-gingival plaque removal.

Preliminary analysis of the antimicrobial activity of a postoperative wound dressing containing chlorhexidine gluconate against methicillin-resistant Staphylococcus aureus in an in vivo porcine incisional wound model

Surgical site infection is a major postoperative complication after surgical procedures. The effectiveness of postoperative antimicrobial dressings in reducing surgical site infections is unclear and limited information is available on the efficacy of chlorhexidine gluconate (CHG)-impregnated postoperative dressings. A pilot study was conducted to examine the efficacy of an innovative CHG-impregnated postoperative dressing in reducing the burden of methicillin-resistant Staphylococcus aureus (MRSA) in an in vivo porcine, incisional-wound model. Sutured incisional wounds were contaminated with MRSA and then covered with a CHG wound dressing, a placebo control, or a nonantimicrobial gauze. The surviving MRSA population was quantitatively cultured 3 days postprocedure. MRSA was not recovered from any of the 8 wounds that were treated with the CHG dressing (limit of detection, approximately 1.7 log10 colony-forming units [cfu]/g tissue). In contrast, the average microbial recovery from wounds treated with the placebo dressing was 4.2 log10 cfu/g and the average microbial recovery from wounds treated with the gauze dressing was 3.2 log10 cfu/g. An innovative CHG dressing provided significant antimicrobial activity against MRSA contaminating a surgical wound in a porcine, incisional-wound model. Future clinical studies are needed to assess the efficacy of the CHG dressing to reduce the bacterial burden in postoperative wounds of surgical patients.

O que usar no preparo cirúrgico da pele: povidona-iodo ou clorexidina?

Objetivo: Discorrer sobre a eficácia do gluconato de clorexidina e do povidona-iodo em soluções aquosas ou alcoólicas na redução de infecçõesdo sítio cirúrgico e na contagem bacteriana da pele, no preparo pré-operatório do paciente. Método: Estudo de reflexão acerca do melhor antisséptico aser usado no preparo cirúrgico da pele. Resultados: Verificou-se que tanto a clorexidina quanto o povidona-iodo são igualmente seguros e efetivos e queos manuais de boas práticas internacionais têm recomendado a sua utilização em soluções alcoólicas. Observou-se uma tendência na indicação da clorexidinaalcoólica e a emergência de estudos que têm avaliado o uso sequencial ou concomitante da clorexidina e do povidona-iodo com resultados favoráveisa essa prática. Conclusão: Há uma tendência mundial mais favorável ao uso da clorexidina alcoólica em detrimento ao povidona-iodo. Contudo,a decisão pelo melhor agente antisséptico deve considerar cada caso clínico, (contra) indicações e situação.

Antimicrobial Efficacy of Chemical and Herbal Agents against Streptococcus mutans: An in vitro study

Objective: To compare and evaluate antimicrobial efficacy of chlorhexidine gluconate and fennel seeds against Streptococcus mutans. Material and Methods: Three agar petri dishes for Streptococcus mutans were prepared. The methanolic extract of fennel seed and 0.2% chlorhexidine were inoculated on the each petri dish and incubated at 37oC for 24 hours. Zone of growth inhibition for each extract was measured in millimeters using antibiotic inhibiting zone measuring scale. Data was analyzed using SPSS statistical software. The comparison of inhibition zone against S. mutans using CHX and fennel seed extract was done using Mann-Whitney and Wilcoxon tests. All statistical analyses were set at a significance level of p<0.05. Results: The mean of zone of inhibition of S. mutans after inoculation with 0.2% chlorhexidine and fennel seed extract are 21.44 ±1.46, 15.34 ±0.74 respectively. There was statistically significant difference in the mean of inhibition zone between 0.2% chlorhexidine and fennel seed against S. mutans (p=0.047). Conclusion: Chlorhexidine and fennel seed are effective in inhibiting the growth of cariogenic bacteria. Therefore, both herbal and chemical agents can be effectively used to reduce pathogenic oral microflora.

The efficacy of chlorhexidine gluconate in canine skin preparation – practice survey and clinical trials

To determine the use in practice and efficacy of different concentrations of chlorhexidine gluconate for canine pre-operative skin preparation. Questionnaires were used to establish which antiseptics and techniques were used for patients undergoing elective neutering. In a clinical study, five different concentrations of chlorhexidine gluconate - 0 per cent (tap water, as a control) 1, 2, 3 and 4 per cent - were tested on 50 dogs undergoing elective ovariohysterectomies and orchidectomies. A variety of preparation practices occurred but only 21 per cent of the veterinary nurses surveyed were aware of the concentration and contact time they used whilst preparing animals. The clinical study revealed there was a significant difference (P<0.001) between the different concentrations used. All concentrations of chlorhexidine were significantly more effective than the control tap water. There was a tendency towards increasing efficacy as concentration increased from 1 to 4 per cent but this was not statistically significant. The lack of significant differences in efficacy between the different concentrations of chlorhexidine gluconate means that current practices may be adequate, although if the chlorhexidine gluconate concentrations and contact times used are unknown, they may be lower than those tested here and, possibly, ineffective, especially if contact times are short.

Factors affecting the efficacy of chlorhexidine gluconate as an antiseptic agent: A pilot study

Factors affecting the efficacy of chlorhexidine gluconate as an antiseptic agent: A pilot study

Efficacy of Chlorhexidine Gluconate During Surgery for Hydatid Cyst

Dissemination of protoscolices-rich fluid during surgery for hydatid cyst disease is a major cause of recurrence. Instillation of a scolicidal agent into a hepatic hydatid cyst before opening is the most commonly employed measure to prevent this serious complication. In this clinical study, the efficacy of 0.04% chlorhexidine gluconate (Chx-Glu) during hydatid cyst surgery was tested, and early-term results were evaluated. A total of 30 consecutive patients with 45 liver cysts were studied. Only type I and type II cysts were included. Cysts were punctured, and fluid was aspirated. The viability of protoscolices in this fluid was determined. Chx-Glu 0.04% was instilled into the cyst cavity. After 5 minutes of exposure, the cyst fluid was reaspirated and evaluated for the viability of protoscolices. Imprints of the germinative membranes were determined for protoscolices viability. All protoscolices in 45 cysts evaluated were killed by 5 minutes of exposure to 0.04% Chx-Glu. The whole of the germinative membrane imprints contained dead protoscolices. Chx-Glu 0.04% did not cause any adverse effect on biliary tracts in communication with cysts. There was no recurrence during the 2-year follow-up period. There were also no mortality and no cavity-related complications. This study shows that intracystic injection of 0.04% Chx-Glu is an effective measure against the dissemination of viable protoscolices. In addition, Chx-Glu is the most convenient scolicidal agent as per the criteria defined by the World Health Organization. Therefore, it can be used safely during hydatid cyst surgery. However, there remains the need to perform advanced comparative clinical studies on the efficacy of Chx-Glu and other scolicidal agents.

Evaluation of the Bactericidal Activity of Chlorhexidine Gluconate and Povidone-Iodine for Hygienic Hand Disinfection.

With the aim of revaluating short-time hygienic hand disinfection in general wards, the efficacy of chlorhexidine gluconate (CHG) and povidone-iodine (PVI) was studied using the glove-juice procedure. In addition, the in vitro bactericidal activity of these antiseptics against 9 different bacterial strains was studied. Test groups of volunteers who disinfected their hands in a basin containing an aqueous solution of either 0.2% CHG or 0.2% PVI showed significantly inferior disinfection efficacy when compared to test groups which applied detergent solutions containing 4% CHG or 7.5% PVI directly onto their palms, scrubbed their hands, and washed the disinfectant away with running water, or to test groups which disinfected their hands by rubbing them with 0.2% CHG in 80% ethanol or 0.5% PVI in 80% ethanol. In addition, for the test groups which used CHG preparations (4% CHG in detergent, 0.2% CHG in 80% ethanol, or 0.2% aqueous CHG), the disinfection efficacy was maintained, even at 90 min after disinfection, as well as immediately after disinfection. However, for the test groups which used PVI preparations (7.5% PVI in detergent, 0.5% PVI in 80% ethanol, or 0.2% aqueous PVI), the disinfection efficacy at 90 min after disinfection was distinctly reduced. Furthermore, it became evident from the results of the in vitro bactericidal activity study that, compared to CHG, the bactericidal efficacy of PVI is reduced to a large extent in the presence of organic matter. These study results showed that the efficacy of CHG is superior to PVI, even in short-time hygienic hand disinfection.