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PubMed1991

The effect of a chlorhexidine rinse on the incidence of alveolar osteitis following the surgical removal of impacted mandibular third molars.

A prospective randomized double-blind placebo-controlled study was conducted with 139 patients (278 bilaterally impacted mandibular third molars) to determine the effect of a perioperative 0.12% chlorhexidine gluconate rinse on the incidence of alveolar osteitis following surgical removal of impacted mandibular third molars. A statistically significant 60% reduction in the incidence of alveolar osteitis was obtained in the chlorhexidine group compared with the placebo group. In most subgroups analyzed, chlorhexidine was associated with at least a 50% reduction in alveolar osteitis compared with control groups.

Adolescent↗
PubMed1992

Evaluation of the substantivity of a chlorhexidine oral rinse in irradiated head and neck cancer patients.

A trial was conducted to evaluate the substantivity of chlorhexidine in a population of patients who had undergone primary or adjunctive radiation therapy for tumors of the head and neck. Subjects were instructed to first rinse with 0.12% chlorhexidine as per manufacturer instructions, followed by a releasing rinse provided 1 minute, 1 hour, and 4 hours later. All expectorants were collected, pH adjusted, and introduced to the test microorganism. Zones of bacterial inhibition were then measured and recorded. The results suggest that 0.12% chlorhexidine is retained in the oral cavity for at least 4 hours after an initial rinsing and that the property of substantivity remains active in spite of radiation-induced changes in the oral cavity and salivary glands.

Chemistry, Pharmaceutical↗
PubMed1993

Sensitive high-performance liquid chromatographic assay for the determination of chlorhexidine in saliva.

A high-performance liquid chromatographic assay was developed to determine salivary chlorhexidine concentration. Saliva sample (200 microliters) was extracted into methylene chloride. Chromatographic separation was achieved with a C18 column using a mobile phase of acetonitrile-0.05 M sodium acetate and 0.005 M heptanesulfonic acid (40:60, v/v). The standard curve was linear from 0.051 to 20.48 micrograms/ml (r2 > or = 0.997). Intra-day and inter-day coefficients of variation were < 5.5 and < or = 9%, respectively. The assay is rapid, sensitive, simple, and successfully used for quantitating salivary chlorhexidine content released from a chlorhexidine-impregnated resin worn by patients.

Chlorhexidine↗
PubMed2004

An in vitro study of the anti-microbial efficacy of a 1% silver sulphadiazine and 0.2% chlorhexidine digluconate cream, 1% silver sulphadiazine cream and a silver coated dressing.

UNLABELLED: Burn sepsis is a leading cause of mortality and morbidity in patients with major burns. The use of topical anti-microbial agents has helped improve the survival in these patients. There are a number of anti-microbials available, one of which, Silvazine (1% silver sulphadiazine (SSD) and 0.2% chlorhexidine digluconate), is used only in Australasia. No study, in vitro or clinical, had compared Silvazine with the new dressing Acticoat. This study compared the anti-microbial activity of Silvazine, Acticoat and 1% silver sulphadiazine (Flamazine) against eight common burn wound pathogens. METHODS: Each organism was prepared as a suspension. A 10 microl inoculum of the chosen bacterial isolate (representing approximately between 10(4) and 10(5) total bacteria) was added to each of four vials, followed by samples of each dressing and a control. The broths were then incubated and 10 microl loops removed at specified intervals and transferred onto Horse Blood Agar. These plates were then incubated for 18 hours and a colony count was performed. RESULTS: The data demonstrates that the combination of 1% SSD and 0.2% chlorhexidine digluconate (Silvazine) results in the most effective killing of all bacteria. SSD and Acticoat had similar efficacies against a number of isolates, but Acticoat seemed only bacteriostatic against E. faecalis and methicillin-resistant Staphylococcus aureus. Viable quantities of Enterobacter cloacae and Proteus mirabilis remained at 24h. CONCLUSION: The combination of 1% SSD and 0.2% chlorhexidine digluconate (Silvazine) is a more effective anti-microbial against a number of burn wound pathogens in this in vitro study. A clinical study of its in vivo anti-microbial efficacy is required.

Anti-Infective Agents, Local↗
PubMed2005

Comparison of silver-coated dressing (Acticoat), chlorhexidine acetate 0.5% (Bactigrass), and fusidic acid 2% (Fucidin) for topical antibacterial effect in methicillin-resistant Staphylococci-contaminated, full-skin thickness rat burn wounds.

Acticoat, chlorhexidine acetate 0.5%, and fusidic acid 2% were compared to assess the antibacterial effect of an application on experimental 15% BSA, full-thickness burn wounds in rats swabbed 24 h earlier with a 10(8) standard strain of methicillin-resistant Staphylococci. The swabbed organism was recovered from the eschar of all groups except the fusidic acid group. While there were significant differences between treatment groups and control group, the mean eschar concentrations did not differ significantly between the Acticoat and chlorhexidine acetate groups, but there were significant differences between the fusidic acid group and the other treatment groups. There were no statistically significant differences between treatment groups, and between control group and the chlorhexidine acetate group regarding recovery of the seeded organism from muscle, but there were significant differences between the control group and Acticoat group, and between control the group and the fusidic acid group. While no systemic spread was seen in the treatment groups, it was seen in six animals in the control group. The animal data suggest that fusidic acid is the most effective agent in the treatment of methicillin-resistant Staphylococcus aureus-contaminated burn wounds, and Acticoat is a choice of treatment with the particular advantage of limiting the frequency of replacement of the dressing.

Administration, Topical↗
PubMedDate not supplied

Duration of action of a single, early oral application of chlorhexidine on oral microbial flora in mechanically ventilated patients: a pilot study.

OBJECTIVE: The purpose of this study was to describe the effect of an early post-intubation oral application of chlorhexidine gluconate on oral microbial flora and ventilator-associated pneumonia. METHODS: Thirty-four intubated patients were randomly assigned to chlorhexidine gluconate by spray or swab or to control group. Oral cultures were done at study admission, 12, 24, 48, and 72 hours, whereas the Clinical Pulmonary Infection Score (CPIS) was documented at study admission, 48, and 72 hours. RESULTS: Reductions in oral culture scores (less growth) were only found in the treatment groups (swab and spray); no reduction was found in the control group. There was a trend for fewer positive cultures in the combined treatment groups. The mean CPIS for the control group increased to a level indicating pneumonia (4.7 to 6.6), whereas the CPIS for the treatment group increased only slightly (5.17 to 5.57). CONCLUSIONS: Trends in the data suggest that use of chlorhexidine gluconate in the early post-intubation period may mitigate or delay the development of ventilator-associated pneumonia.

Adult↗
PubMed2004

Effect of beta-sitosterol on the characteristics of vesicular gels containing chlorhexidine.

Previous studies confirm that beta-sitosterol is very effective in altering the molecular packing of soybean lecithin bilayers even more than the cholesterol. The primary aim of the present study was to evaluate the influence of the beta-sitosterol portion in the lipid bilayer on the physical-chemical characteristics of the prepared gel systems, and its influence on the consequent drug release from the liposomes obtained from vesicular phospholipid gels (VPG-s) by redispersion. VPG-s were prepared of different molar ratios of lecithin:sterol components (10:90-35:65 mol%). The mixture was hydrated with the aqueous solution of chlorhexidin digluconate in order to achieve 30% (w/w) final concentration of the lipid mixtures and 4% (w/w) concentration of the drug in each homogenized VPG sample. To characterize the obtained VPG systems optical microscopic examinations using polarized light, differential scanning calorimetry (DSC), photon correlation spectroscopy (PCS), and dynamic surface tension measurements were carried out. Vertical type diffusion cell was applied to determine the amount of released chlorhexidine digluconate. As a result of the surface tension-decreasing effect of beta-sitosterol, the membrane deformability and the dispersity of the system increased. The increased dispersity and fluidity significantly increased the extent of released chlorhexidine from the vesicles.

Chlorhexidine↗
PubMed2004

Effectiveness of topical chlorhexidine powder as an alternative to hexachlorophane for the control of Staphylococcus aureus in neonates.

We routinely phage-type Staphylococcus aureus isolates from high-risk inpatients each week. This surveillance approach previously identified a five-year outbreak of a methicillin-susceptible S. aureus strain (MSSA, PT 53,85), which affected 202 babies on a regional neonatal unit. We previously reported this outbreak and the multiple staged infection control measures that were required to end it. These included strict emphasis on hand hygiene, environmental and staff surveillance sampling, application of topical triclosan solution and hexachlorophane powder, aseptic handling of a skin protectant material, and use of topical mupirocin for staff nasal carriers of the endemic MSSA strain and for babies colonized or infected with S. aureus. In summer 2000 topical hexachlorophane powder became unavailable and we therefore substituted topical 1% chlorhexidine powder as part of routine umbilical decontamination. We have continued prospective S. aureus surveillance for the past five years to monitor the effect of this practice change. We observed a continued decline in the numbers of monthly MSSA isolates from neonatal unit babies. Since the substitution of chlorhexidine for hexachlorophane, the median monthly number of MRSA isolates has been 0.5 (range 0-4). Only sporadic S. aureus PT 53,85 isolates were recovered. Control of S. aureus in our regional neonatal unit, in particular an endemic MSSA strain, was maintained when topical umbilical hexachlorophane powder was substituted with 1% chlorhexidine powder.

Administration, Topical↗
PubMed2006

The effects of sodium hypochlorite (5.25%), Chlorhexidine (2%), and Glyde File Prep on the bond strength of MTA-dentin.

The purpose of this study was to evaluate the effects of sodium hypochlorite (5.25%), chlorhexidine (2%), and Glyde File Prep on the bond strengths of MTA-dentin in vitro. Standardized dentin disks were prepared and the central hole in each disk was filled with mineral trioxide aggregate (MTA). The specimens were randomly divided into four groups to be immersed in saline, 5.25% NaOCl, 2% chlorhexidine, and Glyde File Prep for 2 hours. The bond strengths of MTA-dentin were measured with a material testing system (MTS) and the fractured surfaces on the root walls were observed by scanning electron microscopy. Compared with the control group, the bond strengths were significantly lower in Glyde File Prep group (p < 0.05) and there was no significant difference in the chlorhexidine group or in the NaOCl group (p > 0.05). This study suggested that Glyde File Prep could negatively affect the bond strengths of MTA-dentin.

Aluminum Compounds↗
PubMed2006

Killing of Enterococcus faecalis by MTAD and chlorhexidine digluconate with or without cetrimide in the presence or absence of dentine powder or BSA.

The antibacterial efficacy of irrigating solutions and local disinfectants used in endodontics appears poorer in vivo than in vitro. One explanation may be inactivation by compounds present in the root canal. MTAD (a mixture of tetracycline isomer, acid, and detergent) is a new root canal irrigation solution with antibacterial activity. The aim of this study was to investigate the antibacterial activity of MTAD and chlorhexidine towards two strains of Enterococcus faecalis and the inhibitory effects of dentine and bovine serum albumin on the antibacterial activity. Survival of bacteria exposed to the medicaments in the presence or absence of inhibitors was monitored in an in vitro model. Full concentration (100%) MTAD and 0.2% chlorhexidine rapidly killed both strains. Combining chlorhexidine with cetrimide further reduced the time required for killing. The presence of dentine or BSA caused a marked delay in killing by both medicaments. The two E. faecalis strains tested showed minor differences in their susceptibility to the disinfectants.

Animals↗
PubMed2007

Comparison of 5.25% sodium hypochlorite, MTAD, and 2% chlorhexidine in the rapid disinfection of polycaprolactone-based root canal filling material.

The purpose of this investigation was to compare the effectiveness of 5.25% sodium hypochlorite, MTAD, and 2% chlorhexidine in the rapid disinfection of Resilon pellets. Resilon pellets were randomly selected, contaminated with Enterococcus faecalis, and disinfected with 5.25% sodium hypochlorite, MTAD, or 2% chlorhexidine. Positive and negative controls were used. All samples were air dried, washed in sterile water, placed in centrifuge tubes containing BHI broth, and incubated at 37 degrees C for up to 7 days. Broths were visually checked for turbidity and scored for growth. Samples from each experimental and control group were randomly chosen, plated, incubated at 37 degrees C, and checked visually for growth. If growth occurred, a gram stain was performed to identify bacterial species. Results indicate that 5.25% sodium hypochlorite, MTAD, and 2% chlorhexidine were all effective in the rapid disinfection of Resilon and gutta-percha pellets, and a 1-minute immersion was sufficient to disinfect.

Chlorhexidine↗
PubMed1990

Effect of chlorhexidine scrub on postoperative bacterial counts.

Chlorhexidine surgical scrub was left on the surgeon's hands in 50 orthopedic and vascular surgical procedures to determine whether the number of bacteria on the hands could be decreased postoperatively. After a standard 5-minute scrub, one hand was randomly rinsed prior to gloving; the other was lightly patted with a sterile towel, leaving some foam on the hand. The surgeon then gloved and performed the procedure in the usual manner. After the operation, both hands were immersed in a tryptic soy broth for 30 seconds. The broth was then cultured for bacterial species and number. Cases in which glove puncture occurred were not cultured. The results were analyzed using the Wilcoxon signed-rank test. There were fewer bacterial colonies isolated from the hand coated with chlorhexidine scrub versus the other; this difference was statistically significant (p less than 0.005). There also seemed to be a trend towards higher bacterial counts after longer operations; however, the difference was not significant. Neither surgeon noted any evidence of dermatitis during the study. These results suggest that leaving chlorhexidine scrub on the hands during surgery can lead to lower bacterial counts on the surgeon's hands and less chance of wound contamination should glove puncture occur.

Antisepsis↗
PubMed1988

The effect of chlorhexidine and benzydamine mouthwashes on mucositis induced by therapeutic irradiation.

A variety of mouthwashes are frequently used in the management of irradiation-induced mucositis. Benzydamine has recently been introduced for alleviating this condition. Its efficacy as a mouthwash was compared with chlorhexidine in two groups of patients receiving radiotherapy for oral carcinoma. Mucositis and pain were recorded over a 6 week period and oral carriage of Candida species, coliforms and Staphylococcus aureus was assessed using an oral rinse technique. There was no significant difference in the mucositis scores, overall pain scores or the yeast and bacterial species isolated between the two treatment groups. However, 58% (7 out of 12) and 92% (12 out of 13) patients reported oral discomfort when rinsing the mouth with chlorhexidine and benzydamine, respectively. In both groups, the most common coliform isolated was Klebsiella pneumoniae and the carriage of yeasts was significantly greater than that of coliforms. These results indicate that, although the individual patient acceptance of chlorhexidine is better than benzydamine, there is little difference between the two mouthwashes both in controlling pain and mucositis or in the oral carriage of the micro-organisms studied.

Aged↗
PubMed1987

Bladder irrigation with chlorhexidine for the prevention of urinary infection after transurethral operations: a prospective controlled study.

The value of postoperative bladder irrigation with the antiseptic agent chlorhexidine was assessed in a randomized prospective controlled study of men after transurethral operations. In patients with sterile preoperative urine the incidence of postoperative bacteriuria was 12.8 per cent, compared to 36.7 per cent in control patients. The difference is significant (chi-square 5.54, p less than 0.02). On the other hand, chlorhexidine irrigation did not eliminate pre-existing infection. Small amounts of chlorhexidine were demonstrated in the blood of some patients. There was no evidence of damage to the bladder and no toxic side effects.

Administration, Intravesical↗
PubMed1999

In vivo antimicrobial activity of 2% chlorhexidine used as a root canal irrigating solution.

The aim of the present study was to evaluate the in vivo antimicrobial activity of 2% chlorhexidine gluconate (FCFRP-USP) used as a root canal irrigating solution in teeth with pulp necrosis and radiographically visible chronic periapical reactions. Culture techniques and measurement of the inhibition zone were used. Twenty-two root canals of incisors and molars of 12 patients were used. After accessing the canal, the first root canal sample was collected with two sterile paper points that were transferred to a tube containing reduced transport fluid. The root canal was instrumented using chlorhexidine solution. A small sterile cotton pellet was placed at the root canal entrance, and the cavity was sealed with zinc oxide-eugenol cement. The canals were maintained empty for 48 h. Three sterile paper points were then introduced to absorb the root canal fluid (second sample). One paper point was placed on an agar plate inoculated with Micrococcus luteus ATCC 9341 and incubated for 24 h at 37 degrees C, and the other two were submitted to microbiological evaluation. Present in 10 cases at baseline, mutans streptococci was reduced by 100% at the second assessment. Treatment showed an efficiency of 77.78% for anaerobic microorganisms at the second assessment. These data suggest that chlorhexidine prevents microbial activity in vivo with residual effects in the root canal system up to 48 h.

Adolescent↗
PubMed1982

Evaluation of phenoxetol-chlorhexidine cream as a prophylactic antibacterial agent in burns.

A controlled clinical trial was conducted to compare the value of a cream containing 2% phenoxetol and 0.2% chlorhexidine as a prophylactic agent against wound infection in patients with burns affecting up to 15% total body surface area. The acquisition of bacteria was similar in the two treatment groups but the incidence of Staphylococcus aureus in the burns treated with phenoxetol-chlorhexidine cream significantly lower. The incidence of gram-negative bacilli was low in the two treatment groups, and no wound yielded Pseudomonas aeruginosa. Unlike preparations containing silver, phenoxetol-chlorhexidine does not cause electrolyte imbalance or stain materials with which it comes into contact, and it did not produce adverse effects during this trial.

Adolescent↗
PubMed2000

Chlorhexidine release from room temperature polymerising methacrylate systems.

A series of different methacrylate monomers (with either 1 or 2.5% dimethyl-p-toluidine, DMPT) was gelled with poly(ethyl methacrylate) powder (containing benzoyl peroxide) thus forming a room temperature curing system. When doped with 5.625% chlorhexidine diacetate the release from the tetrahydrofurfuryl methacrylate-based samples was considerably greater than that from other methacrylate monomers. This seems to be due to the formation of channels in the polymer. Nuclear magnetic resonance spectroscopy, of solutions that the samples were immersed in, showed chlorhexidine was indeed being released from the polymer. It also showed that doping the polymer with chlorhexidine hindered the polymerisation, resulting in a higher level of residual monomer and low molecular weight components being leached from the polymer. The DMPT also affected the polymerisation with greater leaching from the 2.5% DMPT sample.

Anti-Infective Agents, Local↗
PubMed2003

A method for discrimination of subpopulations of Candida albicans biofilm cells that exhibit relative levels of phenotypic resistance to chlorhexidine.

Microbes in biofilms are generally found to be resistant to antimicrobial agents. One set of hypotheses attributes biofilm resistance to acquisition of special physiological traits (phenotypic resistance). Methods are presented that allow discrimination of subpopulations of Candida albicans cells that exhibit relative levels of phenotypic resistance to chlorhexidine. The assay for phenotypic resistance is based on microscopic detection of the rate of penetration of propidium iodide (PI) into single cells as their membranes become disrupted by chlorhexidine. Using the assay, it was found that batch cultures became progressively more resistant to the action of chlorhexidine during the transition from exponential growth to early stationary phase. Results are presented demonstrating that the methods can be used to characterize relative levels of phenotypic resistance exhibited by cells at the base of a C. albicans biofilm.

Anti-Bacterial Agents↗