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Results for “Chlorhexidine”

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PubMed1982

Nosocomial Pseudomonas cepacia infection associated with chlorhexidine contamination.

During the period of January to July 1980, a marked increase in the number of Pseudomonas cepacia isolates was observed in a microbiologic surveillance program. Although P. cepacia was isolated from wound specimens and vaginal cultures, the majority of isolates were of urinary origin from catheterized patients. Retrospective chart analysis of the patients failed to verify a causal pathogenic role for P. cepacia. However, fulminant sepsis subsequently developed in two hospitalized immunocompromised patients, with both blood and urine cultures positive for P. cepacia. Investigation revealed the presence of this organism in chlorhexidine (0.2 percent) mouthwash as well as other chlorhexidine antiseptic solutions used for routine urologic and obstetric procedures. The source of the P. cepacia was identified as the rubber tubing in the pharmacy through which deionized water passed during the dilution of concentrated (5 percent) chlorhexidine gluconate. In vitro tests demonstrated that P. cepacia was resistant to 0.2 percent chlorhexidine.

Aged↗

PubMed1987

Therapeutic use of chlorhexidine in bone marrow transplant patients: case studies.

Patients undergoing cytotoxic chemotherapy and radiation therapy often experience severe oral complications during and after treatment despite supervised oral hygiene and conventional antimicrobial regimens. The antimicrobial compound chlorhexidine is an effective topical prophylactic agent against oral mucositis and candidiasis. Oral mucositis developed in four patients who underwent bone marrow transplantation; the condition was severe enough to prompt use of chlorhexidine. In each case, there was clinical resolution of mucositis and a concomitant decrease in the oral microbial burden 1 week after chlorhexidine use began. This strongly suggests that, in addition to its value in protecting these severely immunocompromised patients from oral infection, chlorhexidine also offers a therapeutic benefit in the resolution of existing oral infections and of mucositis.

Adult↗

PubMed1989

Effect of chlorhexidine rinsing on the oropharyngeal ecology in patients with head and neck cancer who have irradiation mucositis.

Oral flora is thought to contribute to irradiation mucositis in patients with head and neck cancer. Neglect of oral hygienic care may also contribute to mucositis. The purpose of this prospective, randomized, placebo-controlled, double-blind study was to evaluate the effect of chlorhexidine 0.1% mouthrinses on oral flora and irradiation mucositis. This study included 30 patients with head and neck cancer who had comparable irradiation portals. One group (N = 15) rinsed four times daily with chlorhexidine 0.1%, the other group (N = 15) with a placebo. The oral flora was cultured (oral washing technique) twice before and three times per week during the period of radiotherapy. On the same days, the severity of mucositis was determined. The colonization index of viridans streptococci was significantly reduced only after 5 weeks of chlorhexidine 0.1% treatment. The colonization patterns of Candida species, Streptococcus faecalis, staphylococci, and Enterobacteriaceae, Pseudomonadaceae, and Acinetobacter species were not influenced by 5 weeks of use of chlorhexidine rinses when compared with the placebo. No differences were seen between the two study groups in the development and severity of mucositis. In conclusion, suppression of oral flora and a lowering of the severity of mucositis by means of disinfecting mouthrinses were not successful.

Adult↗

PubMed1991

Chlorhexidine mouthwash-induced fixed drug eruption. Case report and review of the literature.

Various adverse reactions including anaphylactic shock have already been reported after the topical application of chlorhexidine. This article reports for the first time a hypersensitivity reaction in the form of fixed drug eruption after the use of a mouthwash containing chlorhexidine. This report should bring an increased awareness of the possibility of systemic hypersensitivity reaction to chlorhexidine in a previously sensitized person. The report also will add fixed drug eruption to the list of skin hypersensitivity reactions caused by chlorhexidine.

Chlorhexidine↗

PubMed1993

Effects of chlorhexidine during immunosuppressive chemotherapy. A preliminary report.

Immunosuppressive chemotherapy and bone marrow transplantation are increasingly used to treat and, in some cases, cure numerous malignant conditions. The systemic sequelae as a result of these immunosuppressive techniques lead to a host of oral and dental complications. The direct and indirect stomatotoxic effects lead to development of ulcerative, hemorrhagic, or infectious complications that potentially can lead to increased mortality and morbidity. Chlorhexidine was studied to evaluate its broad spectrum antimicrobial properties and to evaluate its effect on immunosuppression-induced mucositis. Our double-blind randomized study revealed that chlorhexidine versus controls had considerable effect in the bone marrow transplant cohort. Patients who received chlorhexidine while undergoing bone marrow transplantation were found to exhibit fewer and less painful mucositis lesions. This study supports prophylactic use of chlorhexidine in patients who undergo bone marrow transplantation.

Antineoplastic Agents↗

PubMed1991

Prospective randomised trial of povidone-iodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters.

More than 90% of all intravascular device-related septicaemias are due to central venous or arterial catheters. To assess the efficacy of cutaneous antisepsis to prevent catheter-associated infection, we prospectively studied three antiseptics for disinfection of patients' central venous and arterial catheter insertion sites in a surgical intensive care unit. 668 catheters were randomised to 10% povidone-iodine, 70% alcohol, or 2% aqueous chlorhexidine disinfection of the site before insertion and for site care every other day thereafter. Chlorhexidine was associated with the lowest incidence of local catheter-related infection (2.3 per 100 catheters vs 7.1 and 9.3 for alcohol and povidone-iodine, respectively, p = 0.02) and catheter-related bacteraemia (0.5 vs 2.3 and 2.6). Of the 14 infusion-related bacteraemias (4 due to contaminated infusate or catheter hub, 10 due to infected catheters), 1 was in the chlorhexidine group and 13 were in the other two groups (odds ratio 0.16, p = 0.04). We conclude that use of 2% chlorhexidine, rather than 10% povidone-iodine or 70% alcohol, for cutaneous disinfection before insertion of an intravascular device and for post-insertion site care can substantially reduce the incidence of device-related infection.

1-Propanol↗

PubMed1987

A hospital outbreak caused by a chlorhexidine and antibiotic-resistant Proteus mirabilis.

An outbreak of urinary-tract infection involving a strain of Proteus mirabilis resistant to gentamicin and several other antibiotics affected 90 patients in Southampton between July 1980 and May 1985. The outbreak strain was also resistant to chlorhexidine and this, in combination with the antibiogram and Dienes' test, permitted differentiation from other P. mirabilis strains. The outbreak had features in common with other Enterobacteriaceae outbreaks, although certain aspects of the population involved have made it particularly difficult to control. The outbreak commenced shortly after the introduction of a catheter care policy which involved the use of chlorhexidine, and although the majority of the cases were colonized before this policy was enforced, chlorhexidine had been used extensively for other procedures within the district. Preliminary evidence suggests that there is no genetic linkage between the chlorhexidine and multiple antibiotic resistance.

Age Factors↗

PubMed1987

The effect of handcream on the antibacterial activity of chlorhexidine gluconate.

A series of handwashing experiments compared the residual effect on Escherichia coli of non-medicated soap, chlorhexidine detergent followed by an anionic handcream, chlorhexidine detergent followed by a non-ionic handcream and chlorhexidine detergent alone. Handcreams containing an anionic emulsifying agent reduced the antibacterial effect of chlorhexidine.

Chlorhexidine↗

PubMed1987

A placebo-controlled trial of the effect of two preoperative baths or showers with chlorhexidine detergent on postoperative wound infection rates.

The effect of preoperative whole-body washing with chlorhexidine detergent on the incidence of postoperative wound infection was assessed in a placebo-controlled trial of 1989 patients. Patients bathed or showered with chlorhexidine, placebo, or conventional bar soap, on two occasions in the 24 h before operation. The overall infection rate for patients treated with chlorhexidine was 9%, against 12.8% in the bar soap and 11.7% in the placebo groups; in the 'clean' surgery group infections were 7.2% against 10.2% and 10%, respectively. The Staphylococcus aureus infection rate in the 'clean' group was 3% for chlorhexidine against 6% for bar soap.

Baths↗

PubMed1990

Hygienic hand disinfection: a comparative study with chlorhexidine detergents and soap.

The efficacy of two chlorhexidine hand-wash detergents and liquid soap was compared in a laboratory trial using artificial contamination of fingers with Micrococcus and Serratia. Agents were assessed for both a rapid and sustained effect after a single contact, and for a cumulative persistent effect after multiple contact over four days. Disinfectant activities were compared by statistical analysis of log reduction factors and log count time gradients (decimal reduction times). The latter analysis attempted to accommodate significant subject variation in response to both agent and organism. All handwashing methods significantly reduced contamination levels. Both chlorhexidine formulations were significantly better than soap in their activity against Micrococcus, but were not more effective than soap in removing contamination with Serratia. Both chlorhexidine preparations showed significant skin persistence and were generally acceptable to subjects after prolonged use. Some effect of the formulation of the hand-wash on chlorhexidine activity was demonstrated.

Chlorhexidine↗

PubMed1990

Surgical hand disinfection: comparison of 4% chlorhexidine detergent solution and 2% triclosan detergent solution.

The effect of 4% chlorhexidine detergent and 2% triclosan detergent on the resident flora of the hands was compared on 20 healthy volunteers. The initial and prolonged effects of the agents were assessed by a modification of the Peterson glove rinse test after multiple hand washes. Chlorhexidine detergent was significantly more effective than triclosan detergent (p less than 0.001) which in turn was more effective than non-medicated soap (p less than 0.001) for both initial and prolonged effect. Chlorhexidine, but not triclosan, showed a significantly greater prolonged effect than initial effect (p less than 0.01). Five volunteers (25%) experienced skin irritation with triclosan; no side effects were experienced with chlorhexidine.

Chlorhexidine↗

PubMed1988

The effect of chlorhexidine irrigation on the incidence of dry socket: a pilot study.

A pilot study was conducted to measure the reported incidence of dry socket following pre-operative irrigation and mouthrinsing with either 0.2% (w/v) chlorhexidine gluconate or normal saline or with no irrigation (control). Three hundred and twenty-four patients presenting for the single extraction of a lower premolar or molar under local anaesthesia were divided into three equal groups; no irrigation, irrigation with saline and irrigation with a 0.2% (w/v) chlorhexidine gluconate solution. After administration of the local anaesthetic agent, 10 ml of the test solutions were applied to the gingival crevice using a blunted needle. The solutions were retained in the patients mouth for 2 min following irrigation. Pre-operative irrigation of the gingival crevice and mouthrinsing with 0.2% (w/v) chlorhexidine gluconate significantly reduced the number of dry sockets. There was no significant reduction in the number of dry socket cases following irrigation and rinsing with normal saline. The irrigation technique, using 0.2% (w/v) chlorhexidine gluconate is safe, inexpensive, easy to apply and can be recommended for routine use in dental practice, to reduce the incidence of dry socket.

Bicuspid↗

PubMed1990

Effects of a chlorhexidine gluconate oral rinse on the incidence of alveolar osteitis in mandibular third molar surgery.

Alveolar osteitis (dry socket) continues to be a frequent sequela of third molar surgery. Chlorhexidine 0.12% used as an oral rinse has been reported to reduce the incidence of dry socket. This study compares the effectiveness of 0.12% chlorhexidine used as a preoperative rinse and immediate postextraction irrigant with 1) similarly used 0.05% cetylpyridium, preoperative chlorhexidine rinse and postextraction saline irrigation, and 2) only postextraction irrigation with normal saline in the reduction of alveolar osteitis in mandibular third molar extractions. The results indicate that chlorhexidine and cetylpyridium were no more effective in the reduction of alveolar osteitis than postextraction irrigation with normal saline.

Adolescent↗

PubMed1988

Comparison of standard and chlorhexidine-derivative topical antibacterial agents on the infected burned rat wound.

The effect of daily treatment with three current topical antibacterial agents and four experimental formulations of chlorhexidine was evaluated after 1 week in rats with full thickness burns. The burn was seeded with 1 x 10(8) colony forming units (CFU) of a strain of P. aeruginosa isolated from the infected wound of a burn patient. Mafenide acetate resulted in the lowest incidence of muscle invasion and yielded the lowest mean eschar and muscle concentrations. Mafenide acetate, gentamicin, and chlorhexidine diphosphanilate (0.5 per cent) had lower mean eschar and muscle concentrations than silver sulphadiazine 1 per cent alone. Addition of chlorhexidine digluconate (0.5 per cent or 1.0 per cent) to silver sulphadiazine reduced mean eschar concentrations but not muscle concentrations compared to silver sulphadiazine alone. All treatments effectively suppressed systemic invasion of lung and blood and prevented death compared with controls. Mafenide acetate, gentamicin sulphate and chlorhexidine disphosphanilate 0.5 per cent were most effective against this patient strain of P. aeruginosa.

Administration, Topical↗

PubMed1992

Clinical effect of subgingival chlorhexidine irrigation on gingivitis in adolescent orthodontic patients.

Twenty-three adolescent orthodontic patients with gingivitis affecting all banded first molars volunteered for the study. Three measures associated with gingivitis (papilla bleeding index, plaque index, and probing depth) were recorded at four sites for all four molars. A single application of subgingival irrigation with 0.12% chlorhexidine digluconate or isotonic saline was performed for 5 seconds at each site. As determined by coin toss, the first molars on the right or left side of the mouth received either chlorhexidine or saline irrigation. The papilla bleeding index, plaque index, and probing depth were recorded before the treatment and subsequently at 2 weeks and then 4 weeks. The gingival bleeding as determined by papilla bleeding index, was virtually eliminated in 4 weeks by a single application of subgingival irrigation with either chlorhexidine or saline. However, there was no significant reduction in pocket depth or plaque index. In addition, no significant difference between the effect of chlorhexidine or saline was found for any of the outcome measures.

Adolescent↗

PubMed2005

Effect of beta-sitosterol concentration and high pressure homogenization on the chlorhexidine release from vesicular gels.

Previous studies have confirmed that the phase transition of vesicular gels of hydrogenated phospholipids to the less ordered fluid vesicular state was induced by the increase of the beta-sitosterol ratio in the whole gel system and consequently in the lipid bilayer. The purpose of the present study was to evaluate the influence of the beta-sitosterol portion in the lipid bilayer and the effect of high pressure homogenization on the structural characteristics of the prepared gel systems. In addition the influence of beta-sitosterol on the consequent chlorhexidine release from the obtained vesicles and liposomes was also examined. Lipid mixtures were prepared from different molar ratios of lecithin:sterol components (90:10-65:35 mol%). The obtained mixtures were hydrated with the aqueous solution of chlorhexidine digluconate in order to achieve a 30% (w/w) final concentration of the lipid mixtures and a 4% (w/w) concentration of the drug. One portion of the resultant multilamellar vesicles was homogenized by using high pressure. To characterize the homogenized and non-homogenized systems, transmission electron microscopy of the freeze-fractured samples and differential scanning calorimetry (DSC) were carried out. A vertical type diffusion cell was applied to determine the amount of released chlorhexidine digluconate. Along with the increase in beta-sitosterol concentration, the fluidity of the membrane as well as its permeability also increased. The increased permeability--caused by the higher beta-sitosterol concentration--and the high pressure homogenization, which increased the dispersity and therefore the surface area, enabled a higher amount of chlorhexidine to be released. The increase of drug release was more pronounced in the case of samples prepared with high pressure homogenization.

Anti-Infective Agents, Local↗

PubMed2006

Effects of sodium hypochlorite and chlorhexidine solutions on Resilon (synthetic polymer based root canal filling material) cones: an atomic force microscopy study.

The aim of the present study is to evaluate the effects of 2% chlorhexidine and 5.25% sodium hypochlorite on the surface properties of Resilon cones with the atomic force microscopy. The Resilon cones were immersed in disinfecting agents (5.25% sodium hypochlorite and 2% chlorhexidine) at 1 and 5 min time intervals. Atomic force microscopy was used to evaluate topographical deviations of Resilon cones. Root mean square (RMS) parameters for topographic amplitudes were calculated. The cones exhibited statistically significant low RMS values at 5-min immersion in sodium hypochlorite and chlorhexidine groups compared to the all other groups (p < 0.05). One-minute immersion did not show any significant deterioration on the Resilon surface (p > 0.05). In conclusion, sodium hypochlorite and chlorhexidine solutions used for disinfection significantly decreased (p < 0.05) the RMS values of Resilon cones at 5-min applications.

Chlorhexidine↗

PubMed2006

Quantitative mapping of chlorhexidine in natural river biofilms.

Soft X-ray scanning transmission X-ray microscopy has been applied to map chlorhexidine, a ubiquitous antimicrobial agent, relative to major biochemical components (proteins, lipids, polysaccharides, Ca2+, K+, CO3(2-)) in natural river biofilms. For the first time, bio-accumulation of chlorhexidine in diatoms has been observed unambiguously. The quantitative results show that chlorhexidine bioaccumulated extensively in lipid-rich regions of diatoms and bacteria. Confocal laser scanning microscopy was used to document changes in the biofilm community. The bioaccumulation provides a significant entry point for chlorhexidine into the aquatic food chain. It results in modification of the biofilm community and it impacts the photosynthetic and protozoan species in particular. X-ray microscopy mapping at high spatial resolution is shown to be a powerful tool for studies of antimicrobial agents in the environment.

Anti-Infective Agents, Local↗