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PubMed2003

Umbilical cord care in premature infants: the effect of two different cord-care regimens (salicylic sugar powder vs chlorhexidine) on cord separation time and other outcomes.

OBJECTIVES: To evaluate the effect of 2 cord-care regimens (salicylic sugar powder vs chlorhexidine as a 4% detergent water solution) on cord separation time and other outcomes in preterm infants. METHODS: A prospective, randomized, controlled trial was conducted on 244 preterm newborns with a gestational age of <34 weeks and a birth weight of <2500 g. All preterm newborns were enrolled, regardless of their health condition. We excluded from the study infants whose conditions during the first hours of life required the catheterization of umbilical vessels. We also excluded from the general statistical analysis all newborns who had their programmed cord-care regimen changed because of the presence or the suspicion of omphalitis. On arrival at our neonatal intensive care unit or neonatal special care unit, infants were bathed thoroughly with a soap solution (Saugella, Guieu, Italy), and the umbilical cord (UC) was treated with 1 of the 2 antiseptic products chosen for the study. The stump was then folded and covered with common sterile, dry gauze and kept in place by an elastic net. Until cord detachment and at every diaper change, the cord stump was cleaned with sterile water and treated with the same product initially used for first-time cord care. On the third day of life, we obtained an umbilical swab either from the base of the cord or from the umbilicus if the cord was already sloughed. Six weeks after birth, during hospitalization or during a follow-up visit if already discharged, all infants had a medical examination to check the umbilicus area. Cord separation time, changing of the programmed cord-care regimen, death, omphalitis, sepsis, cord bleeding, nurses' opinion on treatments efficacy, and UC colonization were measured. RESULTS: The cord separation time was significantly lower in infants who were treated with salicylic sugar powder (6 +/- 2 days) than in infants who were treated with chlorhexidine (9 +/- 2 days). The programmed cord-care regimen was changed in a significantly higher number of newborns in the chlorhexidine group (17) than in the salicylic sugar group (3). None of the newborns died, and we found only sporadic cases of sepsis (1 patient in each group) and omphalitis (1 patient in the chlorhexidine group). A significantly higher percentage of nurses were satisfied with the salicylic sugar powder treatment (98%) than with the chlorhexidine treatment (67%), notwithstanding a more frequent occurrence of slight cord scar bleeding in the salicylic sugar group (7.8%) than in the chlorhexidine group (4%). The rate of negative umbilical swabs was significantly higher in infants treated with salicylic sugar powder (73.1%) than with chlorhexidine (53%). CONCLUSIONS: In neonatal intensive care units and neonatal special care units of developed countries, salicylic sugar powder can be used effectively and safely for UC care of preterm infants.

Administration, Topical↗

PubMed1992

The effects of chlorhexidine digluconate on human fibroblasts in vitro.

The drug chlorhexidine has been widely utilized as a wound antiseptic and oral antimicrobial rinse. There have been numerous reports on its safety as an oral rinse, but its effects on wound healing have been contradictory. The present study utilized human fibroblasts derived from skin and oral tissues to test the effects of chlorhexidine on viability, growth, collagen gel contractions, and total protein synthesis. Cells were exposed for an hour to 0.005% and 0.002% chlorhexidine and for 30 seconds to 0.12% chlorhexidine. Our results indicate that a 0.002% concentration of the drug shows minimal cytotoxicity, but is able to suppress cell division almost completely. Collagen gel contraction, as a model of wound contraction, was also severely affected by all of the concentrations of chlorhexidine used. Total protein synthesis was suppressed by chlorhexidine in collagen gel culture. The data support the hypothesis that chlorhexidine is highly cytotoxic to cells in vitro, but various cell functions such as proliferation, collagen gel contraction, and protein synthesis are affected to different degrees by the drug.

Cell Survival↗

PubMed2000

The effect of chlorhexidine mouthrinses on early bacterial colonization of guided tissue regeneration membranes. An in vivo study.

BACKGROUND: Different membrane materials accumulate varying amounts of bacteria when exposed in the oral cavity, due to their textural and structural surface characteristics. The aim of the study was to evaluate the effect of chlorhexidine mouthrinses on the in vivo early bacterial colonization of 3 different guided tissue regeneration membrane materials. METHODS: Rectangular-shaped strips cut from 3 periodontal membranes (expanded polytetrafluoroethylene, polyglactin 910, and polylactic acid) were glued to removable devices adapted to the 2 upper quadrants in 8 dental students. In each student 1 quadrant was randomly selected as test side while the other served as control side. The experiment was divided in 2 phases: in the first phase plaque accumulation was followed for 4 hours while the second accumulation was followed for 24 hours. During the 4-hour experiment, students rinsed the test device twice (immediately following device application and after 2 hours) with 0. 12% chlorhexidine solution. The control device was rinsed with saline. In the second phase, students rinsed the test device with chlorhexidine and the control devices with saline 3 times (after device application and at 8 and 16 hours). Both the 4-hour and the 24-hour specimens were processed for scanning electron microscopy analysis. Fifty-four fields (at 200x magnification) were randomly selected and analyzed on each strip. Magnification was increased to determine the presence and morphotype of bacteria. The presence or absence of bacteria was assessed in a binomial fashion: the field was bacteria-positive when bacteria constituted the deposits covering the membrane surface. The microscopic field was negative (bacteria-negative) when no bacteria were observed. Bacteria-positive fields showing rods and filaments as prevalent morphotypes were recorded as rod-positive fields. RESULTS: The results of data analysis suggest that bacterial contamination of membrane materials is significantly reduced by treatment with chlorhexidine. They also suggest that other variables affect plaque accumulation as well; i.e., the time allowed (4 versus 24 hours) and the different membrane materials. The interaction between these 2 variables is also highly significant, thereby indicating a different rate of plaque accumulation on different materials, irrespective of the treatment with chlorhexidine. CONCLUSIONS: It was concluded that chlorhexidine mouthrinses may be effective in reducing and delaying the early bacterial accumulation on membrane materials although they are not able to fully prevent it. Membrane surface characteristics seem to be a more critical factor than the use of chlorhexidine, in influencing bacterial adhesion and colonization of barrier materials.

Adult↗

PubMed1983

Oral retention and discoloration tendency from a chlorhexidine mouth rinse.

Individual differences in tooth discoloration have been observed after using chlorhexidine mouth rinses. To study the correlation between retention of chlorhexidine and the discoloration tendency, two groups, 'stainers' and 'non-stainers', were selected. The following parameters were tested: initial retention of chlorhexidine in vivo, retention of chlorhexidine to saliva-coated hydroxyapatite in vitro, and prolonged release of chlorhexidine in vivo. The initial oral retention of chlorhexidine was identical for the two groups, whereas in vitro retention of hydroxyapatite and prolonged release of chlorhexidine in vivo were higher among 'stainers'.

Chlorhexidine↗

PubMed2000

Chlorhexidine and taste. Influence of mouthwashes concentration and of rinsing time.

BACKGROUND: This study aims to define the influence of chlorhexidine on taste, considering either its concentration in mouthwashes or time of rinsing. METHODS: Suprathreshold taste acuity of 40 healthy subjects tasting variously concentrated solutions of sucrose, sodium chloride, citric acid and quinine hydrochloride was determined. Subjects were divided into four groups. Three groups rinsed their mouths during one minute, twice a day, for seven days, with a selected mouthwash (respectively 0.12%, 0.20%, and 0.30% chlorhexidine solutions). The fourth group rinsed in the same manner with a 0.30% chlorhexidine mouthwash, and time of rinsing was 15". RESULTS: All the mouthwashes reduced taste acuity for salt and bitter; the perception of sweet and sour was not significantly modified. Chlorhexidine acted on taste in different ways: salt perception reached the lowest value on the second day of treatment and the degree of hypogeusia changed no more till mouthrinses were interrupted. Bitter perception was progressively reduced and reached the lowest value on the seventh day. In both cases taste reduction lasted some days after the interruption of mouthrinses. Quality of all tastes was altered by mouthwashes, but incidence of dysgeusia was not related to chlorhexidine concentration. CONCLUSIONS: Hypogeusia induced by chlorhexidine concerns specifically salt and bitter. Chlorhexidine concentration in mouthwashes till 0.12% and mucosa exposure not exceeding 60" twice a day, seem the best procedure to protect tastes in clinical practice.

Adult↗

PubMed1989

Oropharyngeal mucositis complicating bone marrow transplantation: prognostic factors and the effect of chlorhexidine mouth rinse.

Oral mucosal ulceration complicating bone marrow transplantation interferes with patients' comfort, nutrition and may lead to systemic infection derived from the mouth. The mucosal injury results from epithelial damage due to the cytotoxic effects of chemotherapy and radiation conditioning as well as from superficial oropharyngeal infection. Because chlorhexidine gluconate is a broad spectrum topical antimicrobial which has been demonstrably effective in preventing oral infection and gingivitis, we performed a randomized, placebo controlled, double-blind trial of chlorhexidine as a mouth rinse in BMT recipients to study the severity of oral mucositis and both oral and systemic infectious complications. One hundred patients were randomly assigned to receive either chlorhexidine gluconate 0.12% mouth rinse or placebo three times daily from the initiation (day -8) of chemoradiotherapy conditioning until day +35 post-BMT. Chlorhexidine use resulted in a trend toward improved oral hygiene index (reduced dental plaque) (p = 0.06) but did not modify the oral mucositis. Patients using chlorhexidine developed a maximum ulceration of 18 +/- 22% of their oral mucosa, while placebo patients ulcerated 25 +/- 31% of the mouth. Ulcerative mucositis was significantly worse in adults compared with children, in individuals who received methotrexate for graft-versus-host disease prophylaxis, and was most prominent on non-keratinized epithelium. Overall, there was no clinically demonstrable additional therapeutic advantage to the use of chlorhexidine in either reducing the mucositis, controlling oral pain, facilitating oral nutrition, shortening hospital stay, or reducing oral infection with herpes simplex virus. There was a trend toward diminished oral candidiasis in chlorhexidine users (p = 0.06).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1986

Factors influencing the immunogenicity of the haptenic drug chlorhexidine in mice. II. The role of the carrier and adjuvants in the induction of IgE and IgG anti-hapten responses.

The roles of carrier and adjuvant in the induction of primary antibody responses to the haptenic drug chlorhexidine (which interacts only electrostatically with proteins) and its N-chlorinated derivative (which binds covalently to proteins) were investigated. N-chloro chlorhexidine, covalently linked to either ovalbumin, KLH, thaumatin, LPS-associated protein or human serum protein, but not autologous mouse serum protein or LPS itself, induced both IgE and IgG anti-chlorhexidine antibody synthesis when injected, with alum adjuvant, into BALB/c mice. Bordetella pertussis (BP) could function as both carrier and adjuvant, but no response was obtained by injection of N-chloro chlorhexidine alone or with alum adjuvant. The immunogenicity of N-chlorinated chlorhexidine was directly related to the degree of its substitution onto the carrier which, in turn, was proportional to the level of chlorine (mM) employed. Chlorine also affected the immunogenicity of the various carriers. In the absence of chlorine, chlorhexidine induced only low level IgG antibody synthesis, but only if presented in a 'pseudoplurivalent' form, as a chlorhexidine-mediated protein precipitate (with alum) or electrostatically bound to a particulate carrier such as BP.

Adjuvants, Immunologic↗

PubMed1996

Chlorhexidine spray effects on plaque accumulation in developmentally disabled patients.

Chlorhexidine gluconate has been studied as an adjunct to standard oral hygiene techniques in developmentally disabled patients in reducing plaque accumulation. The purpose of this double blind crossover study was to determine the efficacy of two concentrations of chlorhexidine spray (0.12% and 0.06%) on plaque accumulation in developmentally disabled patients. Informed consent was obtained for 8 developmentally disabled patients 12 to 33 years of age. Patients were randomly assigned to one of two groups of four each. One group received twice daily 0.12% chlorhexidine spray while the other received the 0.06% chlorhexidine spray for 30 days, followed by twice daily chlorhexidine spray (0.12% and 0.06%) alternating groups, for a period of 30 days. Final plaque indices were determined. Normal oral hygiene practices continued throughout the study. Significant plaque reduction occurred with the 0.12% and 0.06% spray solutions. No significant differences occurred between the two concentrations. The results of this study suggest that twice daily chlorhexidine spray at a concentration of 0.06% is as effective in reducing plaque accumulation as a 0.12% chlorhexidine concentration.

Adolescent↗

PubMed1973

Use of 4 per cent chlorhexidine detergent solution (Hibiscrub) and other methods of skin disinfection.

In a comparison of three antiseptic detergent preparations for hand washing, Hibiscrub, a 4% chlorhexidine detergent solution, caused a significantly greater estimated immediate reduction of skin flora (86.7% +/- 3.0) than was obtained with Dermofax, a 0.75% chlorhexidine detergent solution (55.5% +/- 5.1), or with Disadine scrub, a povidone iodine detergent preparation (68% +/- 6.8). After six applications the mean estimated reductions of skin flora were 99.2% +/- 0.2 for Hibiscrub, 97.7% +/- 0.7 for povidone iodine, and 91.8% +/- 1.6 for Dermofax.After a series of hand washings with Hibiscrub, as with a hexachlorophane detergent preparation, a further large reduction of skin flora, shown by bacterial counts of hand sampling, was obtained by a second phase of disinfection consisting of two minutes' application on gauze swabs of 0.5% chlorhexidine digluconate in 70% ethanol; a further wash with Hibiscrub, in place of alcoholic chlorhexidine, for the second phase of disinfection caused an increase rather than a reduction in the yield of bacteria on skin sampling. Unlike this "two-phase" disinfection, the application for 30 minutes of compresses soaked in 10% aqueous povidone iodine or in 0.5% aqueous chlorhexidine digluconate did not cause a greater reduction in skin flora than that obtained by the conventional two minutes' application on gauze of 0.5% chlorhexidine in 70% ethanol.Chlorocresol (0.3%) liquid soap (the base used for Ster-Zac liquid hexachlorophane soap) caused a mean reduction of skin flora when used for hand washing of 29% after one application and 72% after six applications spread over two days. This formulation, though less active and more variable as a detergent skin antiseptic than chlorhexidine, hexachlorophane, or povidone iodine detergent preparations, is an inexpensive disinfectant soap which could be useful in catering establishments. Alcoholic cetrimide applied as for disinfection of an operation site caused a reduction of skin flora greater than that shown by aqueous cetrimide but comparable to that shown by 70% ethyl alcohol in previous experiments.

Analysis of Variance↗

PubMed2004

Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection.

BACKGROUND: Early-onset group B beta-hemolytic streptococcus (GBS) infection accounts for approximately 30% of neonatal infections, has a high mortality rate and is acquired through vertical transmission from colonized mothers. Several trials have demonstrated the efficacy of intrapartum chemoprophylaxis (IPC) for preventing early-onset disease (EOD). Vaginal disinfection with chlorhexidine during labour has been proposed as another strategy for preventing GBS EOD in the preterm and term neonate. Chlorhexidine has been found to have no impact on antibiotic resistance, is inexpensive, and applicable to poorly equipped delivery sites. OBJECTIVES: To determine the effectiveness of vaginal disinfection with chlorhexidine during labour for preventing early-onset GBS infection in preterm and term neonates. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth trials register (October 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2003), MEDLINE (1966 to October 2003), EMBASE (1980 to March 2003), CINAHL (1982 to March 2003) and LILACS (1982 to September 2003). SELECTION CRITERIA: Randomized and quasi-randomized trials comparing vaginal disinfection with chlorhexidine to placebo, or no treatment. DATA COLLECTION AND ANALYSIS: We extracted information from the results sections of the included studies. We reported relative risk (RR) and risk difference (RD) with 95% confidence intervals (CI) for dichotomous outcomes. We calculated the number needed to treat (NNT) with 95% CIs when a statistically significant RD was found. We used a chi square test (chi2) and the I2 analysis to test for heterogeneity, and applied a fixed or random effects model accordingly. MAIN RESULTS: Five studies, including approximately 2190 term and preterm infants, met the inclusion criteria and reported on at least one of the outcomes of interest for this systematic review. When all studies were combined there was a statistically significant (p = 0.005) reduction in colonisation (RR 0.72, 95% CI 0.56 to 0.91); RD -0.16 (95% CI -0.26 to -0.05); NNT 6 (95% CI 4 to 20). There was no statistically significant between-study heterogeneity. There was no statistically significant between-study heterogeneity both for RR (chi(2) = 3.21 [p = 0.2], I(2) = 37.8%) and for RD (chi(2) = 1.66 [p = 0.44], I(2) = 0%). There was no statistically significant reduction in EOD including GBS infection, GBS pneumonia, GBS meningitis or mortality. REVIEWERS' CONCLUSIONS: Vaginal chlorhexidine resulted in a statistically significant reduction in GBS colonisation of neonates, but was not associated with reductions in other outcomes. The review currently does not support the use of vaginal disinfection with chlorhexidine in labour for preventing EOD. Results should be interpreted with caution as the methodological quality of the studies was poor.

Administration, Intravaginal↗

PubMed1982

In vitro studies into the release of chlorhexidine acetate, prednisolone sodium phosphate, and prednisolone alcohol from cold cure denture base acrylic.

An investigation was carried out into the release of chlorhexidine acetate, prednisolone sodium phosphate, and prednisolone alcohol from a cold cured acrylic denture base material. The drugs were added at 10% w/w with the powder phase of the material. Water, at the concentrations of 10%, 20%, and 30% of the monomer phase of the material was added to chlorhexidine-containing and chlorhexidine-free samples. Spectrophotometric and bioassay measurements of the release of chlorhexidine demonstrated protracted delivery to 140 days. The daily release rate was increased by the addition of water to the material and at 30% water incorporation the release was greater and increased up to 190 days. The release pattern of prednisolone sodium phosphate was similar to that of chlorhexidine without the addition of water. Prednisolone alcohol was released for a much shorter period and at lower levels. Scanning electron microscopic examination of the polished, etched, and fractured surfaces of the material demonstrated that chlorhexidine acetate and prednisolone sodium phosphate were incorporated into the interbead matrix areas of the material. The irregularities in the material increased with the addition of water. Prednisolone alcohol produced minimal changes in the specimens except after soaking in water for 140 days when numerous small defects could be seen in the matrix zones at high magnification. The use of materials such as water to increase porosity appears a simple method of improving the release pattern of drugs from acrylic. However, the strength of the resulting material would require support from an existing intraoral prosthesis or appliance.

Acrylic Resins↗

PubMed2000

The influence of a 0.2% chlorhexidine mouthrinse on plaque regrowth in orthodontic patients. A randomized prospective study. Part II: Bacteriological parameters.

In a prospective plaque regrowth study focusing on oral hygiene during fixed appliance therapy 12 adolescent patients (mean age 14.1 +/- 1.5 years) were evaluated twice over 2-day test periods. In the randomized, double-blind study the influences of a 0.2% chlorhexidine mouthrinse (Corsodyl, CHX) and a commercially available dentifrice supplementing fluoride (Odol-med-3) were compared intra- and interindividually in a crossover design with regard to the bacteriological parameters. The bacteriological parameters of vital fluorescence, bacteriological counts (BC), colony forming units (CFU), plating efficiency (PE) and mutans streptococci (MS) were related to the clinically assessed indices of plaque and gingivitis. All parameters analyzed demonstrated significant differences between the control and the test (chlorhexidine) group. Where-as the values of BC, CFU, and PE progressively increased in the control group from T0 to T2, these parameters distinctly decreased in the chlorhexidine group. All values of vital flora (VF) scored around 75% in the control group compared to values of 30% in the test group. BC, CFU und PE correlated significantly. The score of mutans streptococci persisted or increased in the controls whereas mutans streptococci approached 0 in the chlorhexidine group. Until the 5th day of washout a clear-cut carry over of the chlorhexidine rinse on mutans streptococci as well as on the gingival index was evident. Since dead microorganisms remain on the tooth surface and in order to maintain oral health, chlorhexidine application might advisedly be supplemented by mechanical plaque control.

Adolescent↗

PubMed2004

Evaluation of a triple-lumen central venous heparin-coated catheter versus a catheter coated with chlorhexidine and silver sulfadiazine in critically ill patients.

OBJECTIVE: To compare the incidence of catheter colonization and catheter-related bloodstream infections between heparin-coated catheters and those coated with a synergistic combination of chlorhexidine and silver sulfadiazine. DESIGN: Randomized, controlled clinical trial. SETTING: A 20-bed medical-surgical intensive care unit. PATIENTS: A total of 180 patients requiring the insertion of a trilumen central venous catheter. INTERVENTIONS. Patients were randomized to receive either a trilumen heparin or chlorhexidine and silver sulfadiazine-coated catheter. MEASUREMENTS: Catheter colonization was defined by a semiquantitative catheter tip culture yielding 15 or more colony-forming units or quantitative culture of 1,000 or more colony-forming units/ml. Catheter-related bloodstream infection as the isolation of the same microorganism from a peripheral blood culture and catheter tip. RESULTS: A total of 260 catheters were cultured. Out of 132 heparin-coated catheters, 29 were colonized and out of 128 chlorhexidine and silver sulfadiazine-coated catheters, 13 were colonized ( p=0.03), relative risk RR=2.16 (1.18-3.97). This represents an incidence of 23.5 and 11.5 episodes of catheter colonization per 1,000 catheter-days, respectively ( p=0.0059), RR=2.04 (1.05-3.84). Microorganisms isolated in catheter colonization from heparin-coated catheters were gram-positive cocci 23, gram-negative bacilli 7, and Candida spp 4. In chlorhexidine and silver sulfadiazine-coated catheters were gram-positive cocci 6 and gram-negative bacilli 11 ( p=0.009). The incidence of catheter-related bloodstream infections per 1,000 catheter-days was 3.24 in heparin-coated catheters and 2.6 in chlorhexidine and silver sulfadiazine-coated catheters ( p=0.79), RR=1.22 (0.27-5.43). CONCLUSIONS: In critically ill patients the use of trilumen central venous catheters coated with chlorhexidine and silver sulfadiazine reduced the risk of catheter colonization due to prevention of gram-positive cocci and Candida spp.

Adult↗

PubMed1995

Effects of chlorhexidine on human taste perception.

Chlorhexidine gluconate at a dose used to control bacteria in the mouth has a reversible effect on taste perception. Taste-intensity ratings and taste-quality identification for concentration series of sucrose, sodium chloride, citric acid and quinine hydrochloride were obtained from 15 healthy humans. The participants rinsed with 0.12% chlorhexidine for 3 min twice a day. Each individual was tested 3 times: before the 4-day rinse period, 30 min after the final rinse, and 4 days after the rinse period. Chlorhexidine rinses reduced the perceptual intensity of sodium chloride and quinine hydrochloride, not sucrose or citric acid. No effects on taste perception were detected 4 days after the rinse period. The identification of sodium chloride as salty was seriously impaired by chlorhexidine but the identification of quinine hydrochloride as bitter was not affected. Specific sites of action of chlorhexidine on the taste epithelium are not known but its effects on salty taste may be related to its strong positive charge and its effect on bitter taste may be related to its amphiphilicity. Chlorhexidine has promise as a probe of taste transduction, as well as for the management of salty/bitter dysgeusias in humans.

Adult↗

PubMed2004

A novel polymeric chlorhexidine delivery device for the treatment of periodontal disease.

An implantable, anti-microbial delivery device for the treatment of periodontal disease has been developed. In this polymer-based delivery system, the encapsulation efficiency, release characteristics, and bioactivity of anti-microbial agent were controlled by the complexation of the drug with cyclodextrins of differing lipophilicity. Microparticles of poly(dl-lactic-co-glycolic acid) (PLGA) containing chlorhexidine (Chx) free base, chlorhexidine digluconate (Chx-Dg) and their association or inclusion complex with methylated-beta-cyclodextrin (MBCD) and hydroxypropyl-beta-cyclodextrin (HPBCD) were prepared by single emulsion, solvent evaporation technique. It was observed that encapsulation efficiency and release of the chlorhexidine derivatives from the microparticles was a function of the lipophilicity of the cyclodextrin. Complexation of the poorly water soluble Chx with the more hydrophilic HPBCD resulted in 62% higher encapsulation efficiency and longer duration of sustained release over a 2-week period than complexation with the more lipophilic MBCD. In contrast, the complexation of the more water-soluble derivative of chlorhexidine, Chx-Dg, with the more lipophilic MBCD improved encapsulation efficiency by 12% and prolonged its release in comparison to both the free Chx-Dg and its complex with HPBCD. Furthermore, it was observed that the initial burst effect could be diminished by complexation with CD. Preliminary studies have shown that the chlorhexidine released from PLGA chips is biologically active against bacterial population that is relevant in periodontitis (P. gingivalis and B. forsythus) and a healthy inhibition zone is maintained in agar plate assay over a period of at least a 1-week. The PLGA/CD delivery system described in this paper may prove useful for the localized delivery of chlorhexidine salts and other anti-microbial agents in the treatment of periodontal disease where prolonged-controlled delivery is desired.

Anti-Infective Agents, Local↗

PubMed2006

DNA damage in multiple organs after exposure to chlorhexidine in Wistar rats.

Since chlorhexidine is effective against microorganisms, it is widely recommended in dentistry. However, studies have provided evidence that chlorhexidine is toxic for a variety of cell types. In order to identify potential genotoxins in different cell types, the purpose of this study was to investigate whether chlorhexidine digluconate is able to cause, in terms of DNA damage, alterations in leukocytes, liver, kidney and urinary bladder by the single cell gel (comet) assay. Ten male Wistar rats were divided into two groups: a negative control and the experimental group treated with 3ml of 0.12% chlorhexidine digluconate by gavage once a day for 8 days. Statistically significant increases of DNA damage was observed in leukocytes and kidney cells of the chlorhexidine digluconate treated group as depicted by the mean tail moment. Taken together, the data indicate that leukocytes and kidney cells are potential targets for primary DNA damage following oral exposure to chlorhexidine digluconate as detected by single cell gel (comet) assay.

Animals↗

PubMed1997

Chlorhexidine versus sterile water vaginal wash during labor to prevent peripartum infection.

OBJECTIVE: Our purpose was to determine whether a dilute solution of chlorhexidine used as a one-time vaginal wash intrapartum can reduce the incidence of intraamniotic infection or endometritis in laboring pregnant women. STUDY DESIGN: Term pregnant women in labor were prospectively randomized to receive either 20 ml of 0.4% chlorhexidine (n = 481) or 20 ml of sterile water (n = 466) placebo. All patients were monitored for risk factors associated with intraamniotic infection. Continuous variables were compared with the Mann-Whitney U test and discrete variables were compared with Fisher's exact test. RESULTS: No significant differences in infection were found between the chlorhexidine and placebo groups. During the study period 21 of 466 women (4.5%) had intraamniotic infection in the control group compared with 25 of 481 women (5.2%) receiving chlorhexidine (p = 0.65, 95% confidence interval 0.82 to 1.41). Nine women in the placebo group (1.9%) and 9 women in the chlorhexidine group (1.9%) had endometritis (p = 1.0, 95% confidence interval 0.62 to 1.56). CONCLUSIONS: Our findings suggest that a one-time 0.4% chlorhexidine vaginal wash does not decrease the incidence of infectious morbidity in parturients, compared with the use of sterile water.

Adult↗

PubMed1997

Residual antimicrobial activity after canal irrigation with chlorhexidine.

We previously reported that the in vitro antimicrobial activity of a 2.0% chlorhexidine endodontic irrigant was equivalent to that of 5.25% sodium hypochlorite. The purpose of this study was to determine if chlorhexidine irrigants could instill substantive antimicrobial activity in instrumented root canals in vitro. Human teeth were instrumented using 2.0% or 0.12% chlorhexidine as irrigants. After instrumentation, the root canals were filled with sterile water, and samples of the root canal fluid were absorbed with paper points at 6, 12, 24, 48, and 72 h after treatment. The paper points were assayed for antimicrobial activity by placing them on agar plate surfaces inoculated with Streptococcus mutans and measuring zones of inhibition. Antimicrobial activity was present in all 2.0% chlorhexidine-treated teeth throughout the 72-h testing period and in most teeth, in relatively lower concentrations, for 6 to 24 h after irrigation with 0.12% chlorhexidine. These results indicate that chlorhexidine instills substantive antimicrobial activity when used as an endodontic irrigant.

Analysis of Variance↗