SEARCH · PubMed Health

Results for “Chlorhexidine”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources

PubMed2006

Topical applications of chlorhexidine to the umbilical cord for prevention of omphalitis and neonatal mortality in southern Nepal: a community-based, cluster-randomised trial.

BACKGROUND: Omphalitis contributes to neonatal morbidity and mortality in developing countries. Umbilical cord cleansing with antiseptics might reduce infection and mortality risk, but has not been rigorously investigated. METHODS: In our community-based, cluster-randomised trial, 413 communities in Sarlahi, Nepal, were randomly assigned to one of three cord-care regimens. 4934 infants were assigned to 4.0% chlorhexidine, 5107 to cleansing with soap and water, and 5082 to dry cord care. In intervention clusters, the newborn cord was cleansed in the home on days 1-4, 6, 8, and 10. In all clusters, the cord was examined for signs of infection (pus, redness, or swelling) on these visits and in follow-up visits on days 12, 14, 21, and 28. Incidence of omphalitis was defined under three sign-based algorithms, with increasing severity. Infant vital status was recorded for 28 completed days. The primary outcomes were incidence of neonatal omphalitis and neonatal mortality. Analysis was by intention-to-treat. This trial is registered with , number NCT00109616. FINDINGS: Frequency of omphalitis by all three definitions was reduced significantly in the chlorhexidine group. Severe omphalitis in chlorhexidine clusters was reduced by 75% (incidence rate ratio 0.25, 95% CI 0.12-0.53; 13 infections/4839 neonatal periods) compared with dry cord-care clusters (52/4930). Neonatal mortality was 24% lower in the chlorhexidine group (relative risk 0.76 [95% CI 0.55-1.04]) than in the dry cord care group. In infants enrolled within the first 24 h, mortality was significantly reduced by 34% in the chlorhexidine group (0.66 [0.46-0.95]). Soap and water did not reduce infection or mortality risk. INTERPRETATION: Recommendations for dry cord care should be reconsidered on the basis of these findings that early antisepsis with chlorhexidine of the umbilical cord reduces local cord infections and overall neonatal mortality.

Administration, Topical↗

PubMed1998

Limited effectiveness of chlorhexidine based hand disinfectants against methicillin-resistant Staphylococcus aureus (MRSA).

Hand disinfectants containing chlorhexidine are thought to be less bactericidal against methicillin-resistant Staphylococcus aureus (MRSA) than methicillin-susceptible Staphylococcus aureus (MSSA). We report an in vitro comparison between three distinct MRSA strains and three MSSA strains. The bactericidal efficacy of chlorhexidine digluconate, 'Hibiscrub' and 'Hibisol' against Staphylococcus aureus was determined in a quantitative suspension test. Logarithmic reduction factors (RF) were calculated for each of six parallel experiments. Chlorhexidine digluconate and 'Hibisol' showed RF > 5 at most concentrations and reaction times but 'Hibiscrub' did not. MRSA was found to be significantly less susceptible than MSSA to chlorhexidine digluconate, 'Hibiscrub' and 'Hibisol' (P < 0.05; two-tailed t-test for independent samples). 'Hibisol' was significantly more effective against MRSA than 'Hibiscrub' (P < 0.05). Hand disinfectants containing both alcohol and chlorhexidine (e.g., 'Hibisol') are more effective against MRSA than scrubs based only on chlorhexidine ('Hibiscrub') and should be used in clinical practice.

Chlorhexidine↗

PubMed2004

Glass fibre-reinforced composite laced with chlorhexidine digluconate and yeast adhesion.

The aim of this study was to lace dental glass fibre reinforced composite (FRC) prepreg with chlorhexidine digluconate and to examine the adherence of common oral fungal pathogen Candida albicans to FRC made of the prepreg. Four different test and control material groups each comprising 16 test specimens ((5.0 x 5.0 x 0.8) mm3) each were used as substrates for C. albicans adherence. A porous polymer pre-impregnated woven glass fibre prepreg was laced with solution of chlorhexidine gluconate and it was used with autopolymerized denture base polymer to fabricate FRC test specimens. Control group (Group 1) consisted of FRC test specimens stored in water. In Group 2, the test specimens were stored in 10% chlorhexidine digluconate solution for 24 h. Group 3 consisted of specimens fabricated using such fibre reinforcements which were pre-soaked in 20% chlorhexidine digluconate and dried before preparation with denture base resin, and followed by storage of the specimens in water. Group 4 was similar to Group 3 but instead of water storage the specimens were immersed in 10% chlorhexidine digluconate for 24 h. For the candidal adhesion assay the test and control specimens were incubated in standardized suspensions of four different strains of C. albicans, rinsed and prepared for light-microscopy. The mean number of adherent cells in each group was counted microscopically and analysed statistically. There were significantly (P < 0.05) more adherent C. albicans cells found in Group 1 than in the other three groups which did not differ significantly from each other. The lowest numbers of adherent cells were found in Group 3. Pretreating the porous polymer pre-impregnated glass fibre reinforcement with chlorhexidine digluconate result in reduction in the number of adherent yeast cells on the surface FRC material.

Aerosols↗

PubMed2003

Effectiveness of 2% chlorhexidine gel and calcium hydroxide against Enterococcus faecalis in bovine root dentine in vitro.

AIM: To evaluate the effectiveness of 2% chlorhexidine gluconate gel and calcium hydroxide (Ca(OH)2) as intracanal medicaments against Enterococcus faecalis. METHODOLOGY: One hundred and eighty dentine tubes prepared from intact freshly extracted bovine maxillary central incisors were infected in vitro for 7 days with E. faecalis. The specimens were divided into four groups, according to the intracanal medicament used, as follows: Group 1: 2% chlorhexidine gluconate gel; Group 2: calcium hydroxide in a viscous vehicle (polyethyleneglycol 400); Group 3: 2% chlorhexidine gluconate gel + calcium hydroxide and Group 4: Brain Heart Infusion (BHI) broth (control group). The medicaments were placed into the canal lumen and left there for experimental times of 1, 2, 7, 15 and 30 days. After each period, irrigation with sterile saline to remove the medicament was performed and the canals were dried with sterile paper points. Dentine chips were removed from the canals with sequential sterile round burs at low speed. The samples obtained with each bur were immediately collected in separate test tubes containing BHI broth. The tubes were incubated at 37 degrees C and daily observed for microbial growth, visualized by the medium turbidity. RESULTS: Chlorhexidine gel alone completely inhibited the growth of E. faecalis after 1, 2, 7 and 15 days. Calcium hydroxide allowed microbial growth at all experimental times. The combination of chlorhexidine and Ca(OH)2 was effective after 1 and 2 days demonstrating 100% antibacterial action; however, its antibacterial activity reduced between 7 and 15 days. CONCLUSION: Under the conditions of this study, it can be concluded that 2% chlorhexidine gel alone was more effective against E. faecalis than calcium hydroxide (P < 0.05). However, its antibacterial activity depended on how long it remained inside the root canal.

Animals↗

PubMed2002

Association between intensity of chlorhexidine use and micro-organisms of reduced susceptibility in a hospital environment.

The potential for emergence of resistance to biocides has been a concern in recent years. This study tested whether an association exists between the intensity of chlorhexidine use and chlorhexidine susceptibility of micro-organisms isolated from patients in different clinical areas in an acute-care general hospital. Organisms frequently involved in nosocomial infections in the hospital were chosen for study over a six week period: Staphylococcus aureus (60 isolates), coagulase-negative staphylococci (48), Klebsiella pneumoniae (32), Pseudomonas aeruginosa (60), Acinetobacter baumannii (16) and Candida albicans (35). An index of chlorhexidine exposure for each clinical unit was derived for the year preceding organism collection. Chlorhexidine susceptibility was evaluated using agar incorporation minimum inhibitory concentrations (MICs) and disk diffusion. A statistically significant inverse correlation was shown between intensity of chlorhexidine use and the overall susceptibility of all study organisms taken together. There was no association when individual taxa were considered. These findings must be interpreted with caution considering that greater use of chlorhexidine is likely to occur in difficult clinical disciplines where antibiotic use, invasive procedures and other intensive care-related procedures, cross-infection and immunosuppression are all potential confounding factors. There was an excellent correlation between MICs and disk testing, suggesting that disk diffusion might be useful in studies involving more than one biocide.

Bacteria↗

PubMed1998

Effects of various methods of chlorhexidine application on shear bond strength.

Chlorhexidine has been applied on the teeth and over orthodontic appliances during treatment in order to reduce bacterial colonization. The purpose of this study was to determine whether the application of chlorhexidine with or without a sealant, to the etched enamel will affect the shear bond strength and the bracket/adhesive failure modes of orthodontic brackets. A total of 132 extracted third molars were cleaned and then divided into 6 groups of at least 20 teeth each. The teeth were etched with a 37% phosphoric acid gel and a sealant was applied in 5 of the groups. Stainless steel orthodontic brackets were then bonded with the Transbond XT bonding system. The chlorhexidine was applied to the teeth either as a prophylactic paste or as a varnish under the following conditions: (1) as a varnish over the bracket and tooth surfaces after the bonding procedure was completed; (2) as a prophylactic paste containing 0.12% chlorhexidine over the intact enamel i.e., before etching; (3) mixed with the sealant and applied to the etched enamel before bonding, (4) as a varnish applied to the etched enamel with no sealant used; (5) as a varnish over the light cured sealant; and (6) as a varnish over the sealant before the sealant was light cured. All teeth were mounted in phenolic rings and stored in deionized water at 37 degrees C for 48 hours. A Zwick Universal Testing Machine was used to determine shear bond strengths. The residual adhesive on the enamel surface was evaluated with the Adhesive Remnant Index. The analysis of variance and chi square tests were used to compare the six groups. Significance was predetermined at the p < or = 0.05. The findings in this study indicated that shear bond strength was not significantly affected when chlorhexidine was applied; (1) over the bracket and tooth surfaces after the bonding procedure was completed (mean = 12.3 +/- 3.1 MPa), (2) as a prophylactic paste over the unetched enamel surface before the bonding procedure is initiated (mean = 9.6 +/- 2.3 MPa), and (3) when the varnish was premixed with the sealant and applied on the etched enamel surface (mean 11.8 +/- 2.1 MPa). On the other hand, in all the experimental groups in which the chlorhexidine varnish was applied as a layer on the etched enamel surface or over the sealant, shear bond strength values and bracket failure rates were of a magnitude that made them clinically unacceptable.

Acid Etching, Dental↗

PubMed2003

Clinical trial of chlorhexidine vaginal irrigation to prevent peripartal infection in nulliparous women.

OBJECTIVE: The purpose of this study was to determine whether intrapartum chlorhexidine vaginal irrigations prevent peripartal infection in nulliparous women at >or=32 weeks of gestation. STUDY DESIGN: This was a double-blinded, placebo-controlled randomized clinical trial. Vaginal irrigations were performed with 200 mL of 0.2% chlorhexidine solution or sterile saline solution placebo every 6 hours during labor. The primary study outcome was clinically diagnosed maternal peripartal infection: chorioamnionitis or endometritis. Analysis was by intent to treat. RESULTS: One thousand forty-one women were assigned randomly to one of two groups (chlorhexidine therapy, 525 women; placebo, 516 women). The two groups were balanced for risk factors for infection. Rates of peripartal infection were 19.3% in the chlorhexidine group and 17.3% in the placebo group (relative risk 1.1; 95% CI, 0.9-1.4). Major and minor neonatal morbidities were similar between the groups. No major and one minor adverse reaction was attributed to chlorhexidine irrigation. CONCLUSION: Under the conditions of this trial, chlorhexidine vaginal irrigation lacked efficacy in the prevention of clinically diagnosed maternal and neonatal infectious morbidity.

Administration, Intravaginal↗

PubMed2002

Effects of 0.2% chlorhexidine gluconate and amoxicillin plus clavulanic acid on the prevention of alveolar osteitis following mandibular third molar extractions.

OBJECTIVE: The purpose of this study was to evaluate the use of a 0.2% chlorhexidine gluconate and amoxicillin plus clavulanic acid combination as a prophylactic therapy for the prevention of alveolar osteitis after mandibular third molar extractions and to investigate adverse reactions to chlorhexidine. STUDY DESIGN: This randomized, placebo-controlled, parallel group study was conducted in a group of 177 subjects, from which 3 groups were formed. The first group (n = 62) received 0.2% chlorhexidine gluconate, the second group (n = 56) received a 0.2% chlorhexidine gluconate and amoxicillin plus clavulanic acid combination, and the third group (n = 59) received 0.09% sterile saline solution. All patients were recalled for the diagnosis of alveolar osteitis on the third and seventh postoperative days. RESULTS: When patients in the antibiotic group were compared with those in the other 2 groups, a significant reduction in alveolar osteitis was noted (P <.05). An alteration in taste, the bad taste of the solution, and staining of dentures and oral tissues were the major complaints about chlorhexidine. CONCLUSION: It would be more beneficial to use chlorhexidine solution with a beta-lactamase inhibitor-containing antibiotic to enhance its effectiveness for the prevention of alveolar osteitis.

Adult↗

PubMed1994

Effectiveness of liquid soap vs. chlorhexidine gluconate for the removal of Clostridium difficile from bare hands and gloved hands.

OBJECTIVE: To compare liquid soap versus 4% chlorhexidine gluconate in 4% alcohol for the decontamination of bare or gloved hands inoculated with an epidemic strain of Clostridium difficile. DESIGN: C difficile (6.7 log10 colony-forming units [CFU], 47% spores), was seeded onto bare or latex gloved hands of ten volunteers and allowed to dry. Half the volunteers initially washed with soap and half with chlorhexidine, followed by the other agent 1 week later. Cultures were done with Rodac plates at three sites on the hand: finger/thumbtips, the palmar surfaces of the fingers, and the palm. Statistical comparison was by paired Student's t test. RESULTS: On bare hands, soap and chlorhexidine did not differ in residual bacterial counts on the finger/thumbtips (log10 CFU, 2.0 and 2.1, P = NS) and fingers (log10 CFU, 2.4 and 2.5, P = NS). Counts were too high on bare palms to quantitate. On gloved hands, soap was more effective than chlorhexidine on fingers (log10 CFU 1.3 and 1.7, P < .01) and palms (log10 CFU 1.5 and 2.0, P < .01), but not finger/thumbtips (log10 CFU 1.6 with each, P = NS). Residual C difficile counts were lower on gloved hands than bare hands (P < 0.01 to < 0.0001). CONCLUSIONS: The two agents did not differ significantly in residual counts of C difficile on bare hands, but on gloved hands residual counts were lower following soap wash than following chlorhexidine wash. These observations support the use of either soap or chlorhexidine as a handwash for removal of C difficile, but efficacy in the prevention of C difficile transmission must be determined by prospective clinical trials.

Aerosols↗

PubMed2002

Taste confusions following chlorhexidine treatment.

Chlorhexidine, a bitter bis-biguanide antiseptic, is the only known blocker of the human salty taste. In order to characterize the effects of chlorhexidine on stimulus identification, taste confusion matrix (TCM) performance was measured for subjects treated with 1.34 mM chlorhexidine gluconate (n = 9) and water controls (n = 9). Ten stimuli [water, 0.1 M NaCl, 0.1 M KCl, 0.1 mM quinine-HCl (QHCl), 0.1 M monosodium glutamate (MSG), 3 mM citric acid, 0.3 M sucrose and mixtures of NaCl, QHCl and citric acid with sucrose] were presented in 10 replicates for identification from a list of 10 stimulus names. T(10), a measure of performance consistency from information theory, was lower for chlorhexidine-treated subjects (2.02 +/- 0.11 bits) than controls (2.73 +/- 0.11 bits) (P < 0.0001). T(2), an indirect measure of pairwise stimulus discrimination, approached chance levels (0.40 bit) in chlorhexidine-treated subjects for all possible pairs of NaCl, KCl, QHCl and water, as well as pairs composed of sucrose and the NaCl-sucrose and quinine-sucrose mixtures. In controls T(2) values approached perfect scores (1.00 bit) for all stimulus pairs except NaCl-KCl and NaCl-MSG. The results demonstrate a decreased ability to identify taste stimuli that is consistent with alterations in the ability of stimuli to elicit salty and bitter taste perceptions. As a selective, effective, persistent and reversible blocker of taste perceptions, chlorhexidine should prove useful in defining taste mechanisms in humans.

Adult↗

PubMed1985

Decreased susceptibility of Serratia marcescens to chlorhexidine related to the inner membrane.

An isolate of Serratia marcescens (strain 100) obtained from a handwashing solution of chlorhexidine (Hibitane) was found not to release potassium ions when exposed to chlorhexidine as compared to chlorhexidine susceptible clinical isolates of Escherichia coli and Ser. marcescens. Lysozyme-tris-EDTA spheroplast preparations of the Serratia isolates were also tested for potassium ion leakage following exposure to chlorhexidine and it was found that the inner membrane was responsible for the decreased susceptibility of the organism of chlorhexidine. These experiments suggested that the mechanism of increased resistance of strain 100 Ser. marcescens to chlorhexidine was an inner membrane change. The nature of the change is currently unknown.

Cell Membrane↗

PubMed1987

Inhibition of Providencia stuartii cell envelope enzymes by chlorhexidine.

The possibility that chlorhexidine is a specific inhibitor of membrane bound bacterial adenosine triphosphatase (ATPase) was addressed. The in-vitro susceptibilities of several Providencia stuartii cell envelope enzymes, including ATPase, to chlorhexidine were compared. The following concentrations of chlorhexidine were required to cause 50% inhibition of enzyme activity in preparations from chlorhexidine-sensitive strains (MIC 50 mg chlorhexidine/l): ATPase (160 mg/l), succinic dehydrogenase (greater than 300 mg/l), penicillin binding protein 7 (300 mg/l) and beta-lactamase (45 mg/l). Fifty per cent inhibition of the ATPase from a chlorhexidine-resistant strain (MIC 1600 mg/l) was achieved at an in-vitro concentration of 225 mg chlorhexidine/l. Our observations do not support the suggestion that bacterial membrane-bound ATPases are specific targets for chlorhexidine.

Adenosine Triphosphatases↗

PubMed1990

Effect of phenoxyethanol, chlorhexidine and their combination on subgingival plaque bacteria.

The effects of phenoxyethanol, chlorhexidine and a mixture of both on subgingival plaque samples from 44 patients with chronic periodontitis were investigated in vitro. At a concentration of 0.5 mg/ml, chlorhexidine inhibited the growth of all cultivable bacteria in all 44 samples while a comparable effect was achieved with phenoxyethanol only at a concentration of 20 mg/ml. All cultivable bacteria in the samples were inhibited by a mixture of the two agents containing 5 mg/ml of phenoxyethanol and 0.125 mg/ml of chlorhexidine i.e. considerably lower concentrations than when the agents were used separately. Kill times for 99.9% of bacteria in 19 of the plaque samples were less than 15 min using a chlorhexidine concentration of 0.125 mg/ml, but were from 24 to greater than 240 min with 10 mg/ml phenoxyethanol. A mixture of the two agents at these concentrations was more effective than either agent alone with 99.9% kill times of less than 10 min. This investigation has shown that the addition of phenoxyethanol to chlorhexidine results in a mixture which is effective against bacteria found in subgingival plaque samples from patients with chronic periodontitis. It also implies that formulations with lower concentrations of chlorhexidine than those currently in use may be effective as adjuncts in the treatment of chronic periodontitis.

Adult↗

PubMed2003

Treatment of plastic and extracellular matrix components with chlorhexidine or benzalkonium chloride: effect on Candida albicans adherence capacity in vitro.

This study investigates the influence of treatment of plastic and extracellular matrix (ECM) proteins with chlorhexidine or benzalkonium chloride on subsequent adherence of Candida albicans. Three concentrations were tested for each antiseptic: (i) chlorhexidine, MIC (6.25-12.5 mg/L), 80 x MIC and 800 x MIC; and (ii) benzalkonium chloride, MIC (3.12 mg/L), 40 x MIC and 1600 x MIC. Chlorhexidine and benzalkonium chloride activities were correlated with the tested concentrations. Antiseptics used at MIC were unable to modify the adherence to plastic or ECM proteins. Chlorhexidine (80 x MIC) induced a decrease in plastic adherence of 31% of the 15 strains used and an increase in ECM protein adherence of 13% of strains. Benzalkonium chloride (40 x MIC) induced a decrease in adherence to ECM proteins or plastic of 13-27% of strains. Our results indicated that the treatment with 1600 x MIC benzalkonium chloride could induce the opposite effect on adherence, depending on the surface: 60% of the strains showed an increase in their adherence to ECM proteins, whereas 93% of the strains showed a decrease in their adherence to plastic. A similar phenomenon was observed after treatment with 800 x MIC chlorhexidine: 60% of the strains showed an increase in their adherence to ECM proteins, whereas 67% showed a decrease in adherence to plastic. Treatment of medical devices with at least 5000 mg/L of chlorhexidine or benzalkonium chloride could therefore reduce C. albicans adherence to plastic surfaces, but would be unable to prevent fungal adherence to ECM proteins.

Anti-Infective Agents, Local↗

PubMed2001

Vaginal lavage with chlorhexidine during labour to reduce mother-to-child HIV transmission: clinical trial in Mombasa, Kenya.

OBJECTIVES: To evaluate the effect of vaginal lavage with diluted chlorhexidine on mother-to child transmission of HIV (MTCT) in a breastfeeding population. METHODS: This prospective clinical trial was conducted in a governmental hospital in Mombasa, Kenya. On alternating weeks, women were allocated to non-intervention or to intervention consisting of vaginal lavage with 120 ml 0.2% chlorhexidine, later increased to 0.4%, repeated every 3 h from admission to delivery. Infants were tested for HIV by DNA polymerase chain reaction within 48 h and at 6 and 14 weeks of life. RESULTS: Enrolment and follow-up data were available for 297 and 309 HIV-positive women, respectively, in the non-lavage and the lavage groups. There was no evidence of a difference in intrapartum MTCT (17.2 versus 15.9%, OR 0.9, 95% CI 0.6-1.4) between the groups. Lavage solely before rupture of the membranes tended towards lower MTCT with chlorhexidine 0.2% (OR 0.6, 95% CI 0.3-1.1), and even more with chlorhexidine 0.4% (OR 0.1, 95% CI 0.0-0.9). CONCLUSION: The need remains for interventions reducing MTCT without HIV testing, often unavailable in countries with a high prevalence of HIV. Vaginal lavage with diluted chlorhexidine during delivery did not show a global effect on MTCT in our study. However, the data suggest that lavage before the membranes are ruptured might be associated with a reduction of MTCT, especially with higher concentrations of chlorhexidine.

Adult↗

PubMed2002

Development and application of an in vitro susceptibility test for Acanthamoeba species isolated from keratitis to polyhexamethylene biguanide and chlorhexidine.

PURPOSE: To develop a reliable in vitro drug susceptibility test against Acanthamoeba isolates and to determine the minimum cysticidal concentration (MCC) of the drug. METHODS: Doubling dilutions of polyhexamethylene biguanide (PHMB) from 3,200 microg/mL to 3.125 microg/mL and chlorhexidine from 3,200 microg/mL to 1.5625 microg/mL were made in Durham tubes and tested against cysts of 19 Acanthamoeba isolates from keratitis. After the exposure to the drugs for 48 hours, the cysts were washed free of drugs by centrifugation. The deposit (cysts) was cultured on nonnutrient agar plates seeded with heat-killed Escherichia coli. The growth of trophozoites from cysts exposed to each of the dilution was recorded by microscopy to estimate the MCC of the drug. RESULTS: The minimum cysticidal concentration of PHMB varied from 25 microg/mL to 100 microg/mL and that of chlorhexidine varied from 1.56 microg/mL to 100 microg/mL. The mean MCC value for PHMB was 55.26 microg/mL and that for chlorhexidine 32.81 microg/mL. Minimum cysticidal concentration 50 (MCC50) of PHMB and chlorhexidine on Acanthamoeba isolates was 50.0 microg/mL and 25.0 microg/mL, respectively. Anti-Acanthamoeba activity of chlorhexidine was higher than that of PHMB and this was statistically significant (p = 0.036). The end point of the results of this method was the detection of the viable cysts undergoing excystment and multiplication of trophozoites with a reproducible and clear-cut estimation of the MCC of PHMB and chlorhexidine. CONCLUSION: The in vitro method described can be used as a standard test for assay of MCC of drugs on Acanthamoeba isolates and to study the susceptibility pattern of newer water-soluble anti-Acanthamoeba drugs.

Acanthamoeba↗

PubMedDate not supplied

Comparison of silver sulfadiazine 1% with chlorhexidine digluconate 0.2% to silver sulfadiazine 1% alone in the prophylactic topical antibacterial treatment of burns.

Wound bacterial colonization in 118 patients treated with chlorhexidine digluconate 0.2% in silver sulfadiazine 1% applied daily to the burn wounds was compared to that of 135 comparable patients similarly treated with silver sulfadiazine 1%. With chlorhexidine digluconate 0.2% in silver sulfadiazine 1%, colonization by Staphylococcus aureus was less frequent (38%) than with silver sulfadiazine (54%, p = 0.016). No statistical difference was found for colonization by Enterococcus faecalis, Pseudomonas aeruginosa, or Enterobacter cloacae. Washing of the wounds of 65 patients with chlorhexidine gluconate 4% during daily dressing changes was associated with reduced wound colonization by S. aureus (35% versus 51%, p = 0.03) and P. aeruginosa (8% versus 16%, p = 0.08) when compared to the 188 washed with nonantibacterial soap. Chlorhexidine, whether added to the topical agent silver sulfadiazine (chlorhexidine digluconate 0.2%) or in the bath soap (chlorhexidine gluconate 4%), decreased colonization by S. aureus.

Administration, Topical↗

PubMed1998

0.25% chlorhexidine gluconate gel. A protective topical microbicide.

BACKGROUND AND OBJECTIVES: An estimated 4 million new cases of chlamydial infection occur each year. This experiment assessed the effects of a vaginally applied gel formulation of 0.25% chlorhexidine gluconate on chlamydial infection and on the vaginal ecosystem. STUDY DESIGN: Twelve monkeys were treated with a single application of 0.25% chlorhexidine gluconate. These animals were assessed for changes in vaginal flora before and at 30 minutes, 1 day, and 2 days postapplication by microbiologic analysis. Cervical and vaginal tissues were assessed by colposcopy at each time point. Five monkeys received a single application of 0.25% chlorhexidine gluconate gel followed (30 minutes) by a cervical inoculation with Chlamydia trachomatis. Four monkeys were inoculated with Chlamydia only. Cervicovaginal tissues were assessed via modified colposcopy, vaginal swabs were collected for assessment of vaginal flora, and cervical swabs were collected for detection of Chlamydia (culture/ligase chain reaction) at baseline and days 1, 2, and 7 postinoculation. RESULTS: Changes in vaginal flora were minimal in all monkeys. Application of 0.25% chlorhexidine gluconate did not affect adversely vaginal colonization by lactobacilli. All chlamydial infection control monkeys were infected, whereas none of the five monkeys pretreated with chlorhexidine gluconate were positive for C. trachomatis by culture or ligase chain reaction. Colposcopic observations remained largely unchanged in all groups. CONCLUSIONS: A 0.25% chlorhexidine gluconate gel was protective against chlamydial infection in all animals tested, had no adverse effect on the vaginal flora, and had minimal effect on cervicovaginal tissues after a single application.

Administration, Intravaginal↗