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PubMed1988

Reversed-phase thin-layer chromatography used to study the simultaneous effect of pH and ion strength on the lipophilicity of chlorhexidine.

The effect of ion strength and pH value of the eluent on the determination of the lipophilicity of chlorhexidine was studied by reversed-phase thin-layer chromatography. The method has been improved by using various buffers: aqueous solutions of formic, acetic and propionic acids and their sodium salts in different ratios and in various concentrations. Stepwise regression analysis separated the effect of pH value, ion strength and acid type on the lipophilicity of chlorhexidine and proved that the ion strength exerted a higher impact than the pH value did. The effect of alkyl chain length of the acids was of secondary importance.

Buffers↗
PubMed1983

A comparison of triclosan and chlorhexidine preparations with 60 per cent isopropyl alcohol for hygienic hand disinfection.

Four detergent preparations containing triclosan; two alcoholic products, containing triclosan and chlorhexidine respectively, and a detergent preparation containing chlorhexidine were compared with 60 per cent isopropyl alcohol following a single hand wash using Escherichia coli as the test organism. In vitro tests indicated that all had a high activity against hospital pathogens. The triclosan-containing preparations exhibited a significant pathogens. The triclosan-containing preparations exhibited a significant residual activity. Experiments in volunteers showed that 0.5 per cent alcoholic triclosan was significantly more effective than all other preparations tested. All the detergent preparations had an effect similar to that of 60 per cent isopropyl alcohol. None of the seven products evaluated was significantly less bactericidal than 60 per cent isopropyl alcohol.

1-Propanol↗
PubMed1988

A laboratory model for testing agents for hygienic hand disinfection: handwashing and chlorhexidine for the removal of klebsiella.

A model for the laboratory assessment of hygienic hand disinfection is described which closely reproduces handwashing in a ward setting. The model uses a clinically relevant test organism and takes into account the natural antibacterial action of the skin. It also provides a means of measuring any residual antibacterial action after hand disinfection. Using an epidemic multiply-resistant strain of Klebsiella aerogenes K21, 0.5% chlorhexidine in iso-propyl alcohol yielded sterile post-disinfection finger washings more often than 4% chlorhexidine digluconate. Both preparations were more effective than soap and water, and with each residual action was demonstrable. The model is applicable to the laboratory evaluation of hygienic hand procedures and for agents of potential use in defined clinical settings.

1-Propanol↗
PubMed1989

An in-use comparison of chlorhexidine gluconate 4% w/v, glycol-poly-siloxane plus methylcellulose and a liquid soap in a special care baby unit.

The effectiveness and harshness of three hand-wash agents, chlorhexidine gluconate 4%, glycol-poly-siloxane gel and a bland liquid soap were studied in-use in a Special Care Baby Unit (SCBU). Each product was used for consecutive 2-week periods by the same groups of 8 health care workers among the 56 in the SCBU. The first group had normal skin, the second had 'sensitive skin' and the third group were known MRSA nasal carriers. Blood agar and methicillin mannitol salt agar were inoculated before and after hand washing and differences in colony counts calculated. Nursing activities before washing were graded from clean to dirty on an eight-point scale and correlated with before-wash colony counts. Product acceptability was assessed with a self-reporting questionnaire. Chlorhexidine was the most effective product in reducing skin microflora but users preferred to wash with the gel preparation. The sensitive-skin group achieved the best effects from washing, irrespective of the product used. Nasal carriers of MRSA recorded the lowest reduction levels of methicillin-resistant organisms but achieved the same reduction levels as the normal-skin group for other microflora. No relationship could be established between the pre-wash activity and the pre-wash colony count. The weekly MRSA colonization rate in neonates on the SCBU remained unaffected by any of the products tested.

Chlorhexidine↗
PubMed1990

Effective inactivation of human immunodeficiency virus with chlorhexidine antiseptics containing detergents and alcohol.

The antiseptics 4% chlorhexidine gluconate detergent formulation containing 4% isopropyl alcohol (Hibiclens/Hibiscrub) and 0.5% chlorhexidine gluconate in 70% isopropyl alcohol with emollients (Hibistat/Hibisol) efficiently inactivated human immunodeficiency virus (HIV) produced in cell culture within 15 seconds. These antiseptics were completely effective at 1:100 and 1:5 dilutions, respectively. Therefore, use of these products according to the manufacturer's instructions (i.e. undiluted) for routine disinfection of hands following contact with HIV-contaminated materials, as well as immediate disinfection of abrasions or cuts exposed to HIV, should have significant protective effects.

1-Propanol↗
PubMed1991

An evaluation of the user acceptability of chlorhexidine handwash formulations.

Four similar-looking preparations containing 4% chlorhexidine ('Hibiscrub', Surgiscrub', 'Uniscrub', 'Macrocide') were compared in a single-blind, randomized study in a group of 73 volunteers. The volunteers washed their hands with each preparation ten times over 9 h, one preparation day-1 on each of four days over two weeks. The acceptability of the agents was assessed using visual analogue scales which were analysed by paired t-test. There were marked differences between the products. 'Uniscrub' smelled worse (P less than 0.003) and felt worse than the others (P less than 0.003). 'Hibiscrub' lathered well but 'Macrocide' was found easiest to rinse off. 'Hibiscrub' and 'Surgiscrub' were the least irritant and had the best visual appearance. Despite apparent similarities, these chlorhexidine formulations varied in acceptability to users.

Chlorhexidine↗
PubMed1994

The sensitivity to chlorhexidine and cetyl pyridinium chloride of staphylococci on the hands of dental students and theatre staff exposed to these disinfectants.

The aim of this investigation was to study the possible emergence of resistant isolates of the genus Staphylococcus on the hands of dental personnel who use 'Hibiscrub' (chlorhexidine-detergent preparation) and cetyl pyridinium-coated gloves. Resistance was determined by a rate-of-kill technique. In four dental student groups (first, second, third and fourth years) no microorganisms survived 30 min exposure to cetyl pyridinium chloride (CPC) or to chlorhexidine diacetate (CDA). In a theatre staff group, no microorganisms survived 30 s exposure to CPC; and only one of 23 isolates survived 30 min exposure to CDA, but was killed after 60 min exposure. It is concluded that staphylococci resistant to either of these disinfectants do not present a problem in dental students or theatre staff.

Aerosols↗
PubMed1989

Effects of chlorhexidine solution on neutrophil locomotion in vitro.

The aim of this study was to ascertain the effect of low concentrations of chlorhexidine on the locomotor behaviour of neutrophils. A special feature was the use of a direct test of chemotaxis. Neutrophils recovered from peripheral blood of healthy adult volunteers were tested for chemokinesis and chemotaxis in the presence of chlorhexidine. A moderate dose-related direct response was observed in respect of both these parameters. It was also apparent that increasing concentrations of the drug inhibited a greater proportion of cells, so that there was total immobility at 0.2 per cent and many cells appeared lysed.

Adult↗
PubMed1984

Prospective comparison of silver sulfadiazine 1 per cent plus chlorhexidine digluconate 0.2 per cent (Silvazine) and silver sulfadiazine 1 per cent (Flamazine) as prophylaxis against burn wound infection.

Patients with fresh full-thickness burn wounds were randomly assigned to receive wound treatment with daily applications of either 1 per cent silver sulfadiazine plus 0.2 per cent chlorhexidine digluconate cream (Silvazine) or 1 per cent silver sulfadiazine (Flamazine). Fifty-four patients treated with Silvazine were comparable to 67 treated with Flamazine with respect to extent and distribution of burn, age and all aspects of wound and associated treatment. Overall incidence of wound bacterial colonization was less in the Silvazine treated patients (65 per cent versus 88 per cent; P = 0.002). With Silvazine, wound colonization by Staphylococcus aureus was less (41 per cent versus 64 per cent; P = 0.01). Clinical wound infection with Staph, aureus developed in one Silvazine treated patient and five Flamazine treated patients (P = 0.16). Colonization by and infection due to all other organisms did not differ in the two groups. The incidence of graft failure was similar with both agents. In future increasing the concentration of chlorhexidine digluconate above 0.2 per cent might produce an improved prophylactic effect against Gram negative bacteria reported by other authors using the combined agent in in vitro and clinical trials. Silvazine was effective in reducing the incidence of Staph. aureus burn wound colonization without fostering supervening opportunistic infection.

Adolescent↗
PubMed1995

Determination of chlorhexidine in saliva using high-performance liquid chromatography.

A reversed-phase high-performance liquid chromatographic method for the determination of chlorhexidine in saliva is reported. The method developed includes a simple and short sample preparation with a one-step extraction procedure and a short total chromatographic run time of 5 min. In a preliminary pharmacokinetic study with a healthy volunteer the chlorhexidine concentration found in saliva after 12 h was 0.8 microgram/ml.

Calibration↗
PubMed1989

FIA determination of chlorhexidine by means of the precipitation with Cu(II).

The determination of chlorhexidine in pharmaceutical formulations is carried out using flow injection analysis (FIA) with measurement by atomic absorption spectrometry (AAS). The method is based on the formation of a copper-biguanide complex precipitate when the sample is injected into an ammoniacal copper solution. The precipitate is retained on a plastic or paper filtering device. A nitric acid stream dissolves the precipitate and carried the Cu(II) to the AAS detector. The chlorhexidine is determined over the range 5-20 ppm. The influence of interfering substances is investigated.

Biguanides↗
PubMed1991

High-performance liquid chromatographic analysis of chlorhexidine phosphanilate, a new antimicrobial agent.

Chlorhexidine phosphanilate (CHP) is analysed by two separate reversed-phase HPLC methods. CHP was found to be a non-stoichiometric compound with a phosphanilic acid to chlorhexidine ratio of 1.83. By careful choice of solvents, solution pH and HPLC columns, loss of sample due to incomplete dissolution and adsorption to surfaces is avoided. Both methods are shown to be stability-indicating and accurate.

Acid-Base Equilibrium↗
PubMed1991

Problems affecting the liquid chromatographic quantitation of chlorhexidine digluconate in ophthalmic solutions.

A liquid chromatogrpahic (LC) assay was recommended by the Food and Drug Administration of the United States for the uptake and release study of chlorhexidine digluconate (CHDG) in ophthalmic solutions by contact lenses. The results from this and other reversed-phase LC assays of CHDG were inaccurate when the working standard and sample solution matrices were different. The error was caused by binding of the analyte onto the container surface and LC column packings. The loss of chlorhexidine due to binding was dependent upon, and very sensitive to, the counter ions in the sample solutions. Relative to water solutions of CHDG, solutions containing chloride, thiosulphate and edetate reduced the loss of the analyte, while solutions containing borate enhanced the loss. To assay CHDG reliably with reversed-phase LC, the media of the working standard and the sample solutions should be closely matched.

Chlorhexidine↗
PubMed2004

Chlorhexidine release from an experimental glass ionomer cement.

Glass ionomer cements (GIC) can potentially be used as matrices for the slow release of active species, as has been shown previously for fluoride ions. This study investigated the use of an experimental GIC as a carrier for the release of chlorhexidine acetate (CHA) at included concentrations ranging from 0.5% to 13.0% of CHA by weight. Release into water was examined using high-performance liquid chromatography. All measurable chlorhexidine was released within 22 h1/2, however this was less than 10% of the total mass incorporated in the specimens. An increased percentage of CHA incorporated into the powder gave an increased release into the surrounding water. The bulk of the CHA was retained within the cement. For comparison, the surface chemistry of a CHA-containing GIC was examined using X-ray photoelectron spectroscopy before and after prolonged immersion in water. This confirmed retention of a large amount of CHA. Spectra after leaching appeared very similar to those from a CHA-free GIC after immersion in a CHA solution. In order to explore the effect of CHA-inclusion on the cement properties, compressive strengths, working and setting times were also measured. In general, compressive strengths were found to be decreased in direct proportion to the quantity of CHA added, while working and setting times increased.

Anti-Infective Agents, Local↗
PubMed2005

Reduction of exit-site infections of tunnelled intravascular catheters among neutropenic patients by sustained-release chlorhexidine dressings: results from a prospective randomized controlled trial.

Exit-site and tunnel infections of tunnelled central intravascular catheters are a frequent source of morbidity among neutropenic patients and may necessitate catheter removal. They require antimicrobial therapy that increases healthcare costs and is associated with adverse drug reactions. A prospective randomized clinical trial was conducted among adult patients undergoing chemotherapy in a haematology unit. Tunnelled intravascular catheters were randomized to receive the control of a standard dressing regimen as recommended by the British Committee for Standards in Haematology, or to receive the intervention of a sustained-release chlorhexidine dressing. Follow-up data were available in 112 of 114 tunnelled intravascular catheters which were randomized. Exit-site or combined exit-site/tunnel infections occurred in 23 (43%) of 54 catheters in the control group, and five (9%) of 58 catheters in the intervention group [odds ratio (OR) for intervention group compared with control group =0.13, 95% confidence intervals (CI) 0.04-0.37, P<0.001]. More tunnelled intravascular catheters were prematurely removed from the control group than the intervention group for documented infections [20/54 (37%) vs 6/58 (10%), OR=0.20, 95%CI 0.53-0.07]. However, there was no difference in the numbers of tunnelled intravascular catheters removed for all proven and suspected intravascular catheter-related infections [21/54 (39%) vs 19/58 (33%)], or in the time to removal of catheters for any reason other than death or end of treatment for underlying disease. Thus chlorhexidine dressings reduced the incidence of exit-site/tunnel infections of indwelling tunnelled intravascular catheters without prolonging catheter survival in neutropenic patients, and could be considered as part of the routine management of indwelling tunnelled intravascular catheters among neutropenic patients.

Administration, Topical↗