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PubMed2006

Chlorhexidine varnish has caries-reducing potential.

DESIGN: A double-blind, randomised, placebo-controlled clinical trial was conducted. INTERVENTION: Children in the test group received 6-monthly applications of a 40% chlorhexidine varnish whereas children in the control group received a placebo varnish, over the course of 2 years. Clinical examination was undertaken at baseline and after 24 months by two calibrated dentists who did not know to which groups children were assigned. OUTCOME MEASURE: Decayed, missing, or primary filled molar surfaces (dmfs-molar) were monitored. RESULTS: At baseline, there was no significant difference between the mean dmfs-molar scores of the two groups (2.8 vs 2.6; P>0.05 ). After 2 years, 44 children (13%) were lost to follow-up, because some (n=31) had moved to other kindergartens, and some (n=13) objected to the taste of the varnish and refused to be examined. After 2 years, 290 children remained in the study, of whom 155 were in the test group and 135 were in the placebo group. The mean caries increment of the primary molars was 1.0 dmfs-molar in the test-group children and 1.6 dmfs-molar in the placebo group. The difference of 0.6 tooth surface equated to a 37.3% reduction in caries increment (number-needed-to-treat of 3), and was statistically significant (P 0.036; 95% confidence interval, 0.04-1.16). No side-effects (such as soft-tissue lesions and staining of teeth) were found at the 24-month examination. CONCLUSIONS: Six-monthly applications of chlorhexidine varnish were effective in reducing the incidence of dental caries in primary molars.

Comment↗
PubMed2002

Antimicrobial action of Nitens mouthwash (cetyltrimethylammonium naproxenate) on multiple isolates of pharyngeal microbes: a controlled study against chlorhexidine, benzydamine, hexetidine, amoxicillin, amoxicillin-clavulanate, clarithromycin, and cefaclor.

BACKGROUND: Acute oropharyngeal and respiratory tract infections are due to a wide spectrum of microorganisms. The aim of this study was to compare and evaluate the in vitro activity of four antiseptics (cetyltrimethylammonium naproxenate, chlorhexidine, benzydamine, hexetidine) to four antibiotics (amoxicillin, amoxicillin-clavulanate, clarithromycin, cefaclor) on strains of Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pyogenes and Streptococcus pneumoniae. METHODS: Susceptibility tests were performed on 90, aerobic and anaerobic, bacterial strains, isolated from nasopharyngeal swabs and sputum. Minimum inhibitory concentrations (by microdilution) and minimum bactericidal concentrations were determined and compared. RESULTS: Our selected panel of bacteria was highly susceptible to the antiseptics, particularly to chlorhexidine and naproxenate, even more so than two of the most frequently used antibiotics. Data were statistically significant (p < 0.005). CONCLUSIONS: In view of their bactericidal and anti-inflammatory properties, these antiseptics may be effective in controlling the transitory colonization of the oral cavity by microbes that cause or worsen disease in patients with mild infections.

Anti-Bacterial Agents↗
PubMedDate not supplied

Surface-chemical studies on chlorhexidine and related compounds: I. Effects at air-water, n-hexane-water, and hydroxyapatite-water interfaces.

The comparative ability of chlorhexidine diacetate and structurally related compounds to generate surface pressure at air-water and n-hexane-water interfaces, and to adsorb to hydroxyapatite, was determined. The order of effectiveness generally evident was 1-(p-chlorophenyl)-5-n-octylbiguanide acetate is greater than chlorhexidine diacetate 1-(p-chlorophenyl)-5-n-hexylbiguanide acetate is greater than 1-(p-chlorophenyl)-5-n-propylbiguanide acetate is greater than p-chlorophenylbiguanide acetate p-chlorophenylguanidine acetate.

Adsorption↗
PubMed1995

[Study of toxicity of iodophor,glutaradehyde and chlorhexidine to L929 Cells.].

We comparatively studied the toxicity of iodophor,glutaradehyde and chlorhexidine in different concentration and time.The result shows that the toxicity of iodophor to L929 cells is the lowest in all kinds of drug concentration and action time is much lower than that of glutaradehyde and chlorhexidine(P<0.05) with prolonging time.It indicates that iodophor can be used to oral diseases therapy with lower concentration.

English Abstract↗
PubMed2026

Effectiveness of chlorhexidine gluconate-impregnated dressings in preventing central line-associated bloodstream infection in a paediatric intensive care unit: A randomised controlled trial.

OBJECTIVES: To compare the effectiveness and dermatological safety of chlorhexidine gluconate (CHG)-impregnated dressings versus conventional transparent dressings in preventing central line-associated bloodstream infection (CLABSI) in paediatric patients admitted to a PICU. METHODS: A single-blind, randomised controlled trial with a 1:1 allocation ratio was conducted in a tertiary PICU. A total of 250 paediatric patients with a central venous catheter were included (125 per group). Patient characteristics, catheter-related variables, catheter dwell time and skin alterations were recorded. The primary outcome was CLABSI, defined according to CDC/NHSN criteria. Bivariate analyses and multivariable logistic regression were performed, including clinically relevant covariates related to catheter exposure, dressing type, and vaccination status. The trial was registered at ClinicalTrials.gov (NCT07175116). RESULTS: CLABSI incidence was significantly lower in the CHG group compared with the conventional dressing group (2.4% vs. 18.4%; p&#xa0;<&#xa0;0.001). In multivariable analysis, CHG-impregnated dressings were independently associated with reduced CLABSI risk (OR = 0.15; 95% CI: 0.04-0.58). Longer catheter dwell time (OR = 1.13 per day; 95% CI: 1.04-1.22) and absence of complete vaccination (OR = 8.68; 95% CI: 2.48-30.47) were also associated with increased infection risk. Incomplete vaccination showed a similar trend without reaching statistical significance (OR = 6.48; 95% CI: 0.95-44.20). Skin alterations were more frequent in the CHG group (16.8% vs. 11.2%), predominantly in younger infants. CONCLUSIONS: CHG-impregnated dressings were associated with a significant reduction in CLABSI incidence in critically ill paediatric patients, although their use was linked to a modest increase in mild skin reactions. IMPLICATIONS FOR CLINICAL PRACTICE: CHG-impregnated dressings may be considered as part of a multifaceted infection prevention strategy, alongside appropriate catheter management, minimisation of catheter manipulation and proactive skin monitoring, with cautious and individualised use in infants.

Humans↗
PubMed2026

Comparing the efficacy of chlorhexidine and povidone-iodine for surgical site disinfection: a systematic review and meta-analysis from randomized controlled trials.

BACKGROUND: Randomized controlled trials report conflicting evidence on the efficacy of different skin disinfectants for preventing surgical site infection (SSI). METHODS: We systematically searched PubMed, Web of Science, Cochrane Library, and Embase for RCTs published up to February 2025 comparing preoperative skin disinfection with povidone-iodine (PVI) versus chlorhexidine (CH). Primary outcomes were overall, superficial, deep, and organ/space SSI rates. Secondary outcomes included hospital stay, readmission, and reoperation. RESULTS: CH was superior to PVI in preventing overall SSI (26 studies, n = 29,356; RR: 0.89; 95% confidence interval [CI]: 0.80 to 0.99). The overall SSI incidence rate in the CH group was 7.1% (1,045/14,677), compared with 7.8% (1,152/14,679) in the PVI group, equating to an 11% reduction in relative risk and a 0.7% reduction in absolute risk. The number needed to treat to prevent one SSI was 143. CH demonstrated superiority over PVI in preventing superficial SSI (13 studies, n = 16,867; RR: 0.77; 95% CI: 0.64 to 0.92), but not for deep SSI (11 studies, n = 15,842; RR: 1.00; 95% CI: 0.77 to 1.29) or organ SSI (9 studies, n = 9,471; RR: 1.17; 95% CI: 0.89 to 1.53). No significant differences were found in hospital stay, readmission, or reoperation rates between the two groups. CONCLUSION: CH demonstrates statistical superiority over PVI in preventing overall and superficial SSI, though the absolute clinical benefit is modest. No significant differences were observed for deep or organ/space SSI, nor for secondary outcomes including hospital length of stay, readmission, or reoperation rates.

Humans↗
PubMed1998

Influence of triple-lumen central venous catheters coated with chlorhexidine and silver sulfadiazine on the incidence of catheter-related bacteremia.

OBJECTIVE: To evaluate the efficacy of triple-lumen central venous catheters coated with a combination product of chlorhexidine and silver sulfadiazine (CSS) in reducing the incidence of local catheter infection and catheter-related bacteremia. DESIGN: Randomized, controlled trial. SETTING: The surgical intensive care units in a university hospital. PATIENTS: All patients who needed central venous catheterization were randomized to receive either an uncoated triple-lumen catheter (n = 157) or a catheter coated with CSS (n = 151). MAIN OUTCOME MEASURE: Catheters were removed when no longer needed or suspected as a cause of infection. The tip and a 5-cm segment of the intradermal portion of the catheter were cultured semiquantitatively. Blood cultures were obtained when clinically indicated. The remaining segment of catheters coated with CSS were cut and incubated on an agar plate with strains of Staphylococcus aureus and Enterococcus. Zone of inhibition was determined 24 hours later. Data were analyzed by survival and logistic multivariate regression methods. RESULTS: Catheters coated with CSS were effective in reducing the rate of significant bacterial growth on either the tip or intradermal segment (40%) compared with control catheters (52%; P = .04). However, there was no difference in the incidence of catheter-related bacteremia (3.8% [uncoated] vs 3.3% [coated]; P = .81). In vitro activity of catheters with CSS against S aureus was evident up to 25 days but activity against Enterococcus dissipated more quickly over time and was absent by day 4. The most common colonizing organisms were coagulase-negative staphylococcus and enterococcus. Variables that were associated with a significant amount of growth on the tip or intradermal segment were a duration of catheterization of longer than 7 days, jugular insertion site, and the absence of a CSS coating. The use of a guidewire when the catheter was removed was associated with a lower risk of significant bacterial growth. CONCLUSIONS: The use of CSS reduces the incidence of significant bacterial growth on either the tip or intradermal segments of coated triple-lumen catheters but has no effect on the incidence of catheter-related bacteremia. In this patient population, catheters coated with CSS provide no additional benefit over uncoated catheters.

Anti-Infective Agents, Local↗
PubMed1978

Hand-washing degerming: a comparison of povidone-iodine and chlorhexidine.

Two antiseptic preparations for hand washing were compared by the glove-juice method in a crossover study on 10 volunteers. The reference preparation was 7.5% povidone-iodine (Betadine Surgical Scrub); the test agent was 4% chlorhexidine gluconate combined with 4% isopropyl alcohol (Hibiclens). The experimental model included inoculation of the hands with a mixture of Serratia marcescens, Escherichia coli, Providentia stuartii, and Pseudomonas aeruginosa. The reference preparation achieved a reduction ratio in colony counts of 695 to 1 under the conditions of this study. The average postwash colony count after use of 7.5% povidone-iodine was significantly less than the preinoculation colony count. Logarithmic values, and the paired t test applied to them, showed a highly significant difference (p = less than 0.001) in favor of the degerming ability of the reference agent compared to the test agent. These data are of value in the selection of preparations for hand washing and may point the way to quantitative methods for other degerming studies.

Anti-Infective Agents, Local↗
PubMed1979

A bacteriological evaluation of a programme for preoperative total body-washing with chlorhexidine gluconate performed by patients undergoing orthopaedic surgery.

Twenty-eight orthopaedic patients were taught to wash their entire bodies with chlorhexidine gluconate on two consecutive days preoperatively, starting in their homes. The operation field was also washed a third time. A bacteriological evaluation was performed using contact plates. A significant reduction of the skin flora, including Staph. aureus, was registered. No adverse side effects of total body-washing were observed.

Bacterial Infections↗
PubMed1988

Vestibular ototoxicity following intratympanic applications of chlorhexidine gluconate in the cat.

Our previous studies have shown that the disinfectant chlorhexidine gluconate (CH) has an ototoxic effect on the cochlea following its topical application in the middle ear space. The purpose of the present investigation was to demonstrate morphologically if CH also has the potential to injure the vestibular organs in the inner ear and, if so, what structures are most strongly damaged. Nine cats were used for the study. The drug dose of CH and the number of its applications to the middle ear were the same as used in our previous study to produce middle ear injuries. In the 2% CH group of cats pronounced degeneration was found in afferent nerve endings and both types of sensory cells. These nerve terminals showed edematous dilatations and contained degenerated mitochondria. Highly dark-stained degenerated mitochondria were distributed in the sensory cells and the afferent nerve terminals in the 0.05% CH group, but these degenerative changes were much less than in the 2% CH group. No otolithic crystals or synaptic vesicles could be seen in the 2% CH group. The results from this study showed that CH as a disinfectant has an ototoxic effect on the labyrinthine vestibule in which the sensory cell-nerve ending complex is affected as the main target. Even when used in dilute clinical concentrations, vestibular disturbances are a likely complication if the drug solution flows into the middle ear through a perforated eardrum.

Administration, Topical↗
PubMed1995

Toxic keratopathy due to the accidental use of chlorhexidine, cetrimide and cialit.

Due to economical reasons some ophthalmologists are using an irrigating solution made by the hospital pharmacy instead of the commercially available solutions. These irrigating solutions come in bottles which are identical to the ones used for other solutions. During the last three years bottles were accidentally mixed up five times. Consequently, bottles containing solutions such as chlorhexidine, cetrimide, chlorhexidine/centrimide and cialit solutions were used during cataract surgery. This resulted in immediate corneal edema which, in its turn resulted in a bullous keratopathy. Four patients underwent a penetrating keratoplasty. In one patient the cornea was covered with a conjunctival flap. Light microscopy of the corneas included epithelial edema, loss of keratocytes, and a disrupted and sometimes absent endothelial cell layer.

Aged↗
PubMed1991

Effects of chlorhexidine-coated intrauterine device on the bacteriology of the uterine cavity.

Twenty-nine women, aged 31-53 years, scheduled for an abdominal hysterectomy, participated in this study. The patients were divided into three groups. The first received a Multiload MLCu250 intrauterine device (IUD); the second group received a chlorhexidine acetate medicated Multiload MLCu250 IUD; the third group acted as a control group receiving no IUD. Bacteriological cultures of the vagina and ectocervix were taken prior to insertion of the IUD. At hysterectomy, some 18 hours later, specimens were taken from the cervical canal, uterine cavity, and the device itself, for culture of anaerobic and aerobic organisms using a standardized previously validated technique. In three of the nine control patients, organisms were cultured from the uterine cavity. There were no differences between the bacteriological results of the two groups with medicated and non-medicated devices, with regard to the cultures from the cervical canal, uterine cavity or the devices themselves. Nor was there any difference between the control and the IUD group.

Adult↗
PubMed2006

Caries in 4-year-old children after maternal chewing of gums containing combinations of xylitol, sorbitol, chlorhexidine and fluoride.

AIM: To evaluate the effect of maternal use of chewing gums containing combinations of xylitol, sorbitol, chlorhexidine and fluoride on caries prevalence in a group of mother's 4-year-old children. STUDY DESIGN: Randomised controlled trial. METHODS: After screening 416 women with newborn babies, 173 mothers with high counts of salivary mutans streptococci (MS) were randomly assigned into three experimental chewing gum groups containing A) xylitol (n=61), B) chlorhexidine/xylitol/sorbitol (n=55), and C) sodium fluoride/xylitol/sorbitol (n=57). The intervention started when each child was 6 months old, was terminated one year later. All of the mothers were instructed to chew one piece of the appropriate gum for 5 minutes, three times a day. The outcome measure was the presence of cavitated and non-cavitated (enamel) lesions in the primary dentitions of the children at the age of 4 years. RESULTS: The drop-out rate in the experimental groups was 15-20%. The mean defs, on examination at aged 4 years was 0.4 +/-1.0 in group A, 0.7 +/-1.7 in group B and 1.4 +/-3.0 in group C. The difference between group A and C was statistically significant (p<0.05). CONCLUSIONS: Less caries was observed in children of mothers who chewed gums with xylitol as the single sweetener during the time of eruption of the first primary teeth compared with those who used gums containing fluoride, sorbitol and lower amounts of xylitol.

Adolescent↗
PubMed2006

[Use of a chlorhexidine-fuchsin solution for ear, nose and throat diseases].

Castellani's solution can no longer be used for medication due to the critical status of its ingredients. A solution of chlorhexidine and fuchsin is proposed as an alternative. This has good antimicrobial effectiveness and can be used in difficult cases of otitis externa solution for the treatment of cavities after mastoidectomy. The literature indicates that the use of this solution is admissible for selected cases in the field of ear, nose and throat diseases.

Administration, Topical↗
PubMed2004

Prevention of intravascular catheter-related infection with newer chlorhexidine-silver sulfadiazine-coated catheters: a randomized controlled trial.

BACKGROUND: The indication of antiseptic-coated catheters remains debated. OBJECTIVE: To test the ability of the new generation of chlorhexidine-silver and sulfadiazine-coated catheters, with enhanced antiseptic coating, to reduce the risk of central venous catheter (CVC)-related infection in ICU patients. DESIGN: Multicentre randomized double-blind trial. PATIENTS AND SETTING: A total of 397 patients from 14 ICUs of university hospitals in France. INTERVENTION: Patients were randomized to receive an antiseptic-coated catheter (ACC) or a standard non-coated catheter (NCC). MEASUREMENTS: Incidence of CVC-related infection. RESULTS: Of 367 patients having a successful catheter insertion, 363 were analysed (175 NCC and 188 ACC). Patients had one (NCC=162, ACC=180) or more (NCC=13, ACC=11) CVC inserted. The two groups were similar for insertion site [subclavian (64 vs 69)] or jugular (36 vs 31%)], and type of catheters (single-lumen 18 vs 18%; double-lumen 82 vs 82%), and mean (median) duration of catheterisation [12.0+/-11.7 (9) vs 10.5+/-8.8 (8) days in the NCC and ACC groups, respectively]. Significant colonisation of the catheter occurred in 23 (13.1%) and 7 (3.7%) patients, respectively, in the NCC and ACC groups (11 vs 3.6 per 1000 catheter-days; p=0.01); CVC-related infection (bloodstream infection) occurred in 10 (5) and 4 (3) patients in the NCC and CC groups, respectively (5.2 vs 2 per 1000 catheter days; p=0.10). CONCLUSIONS: In the context of a low baseline infection rate, ACC were associated with a significant reduction of catheter colonisation and a trend to reduction of infection episodes, but not of bloodstream infection.

Anti-Infective Agents, Local↗
PubMed2004

Reduction of catheter-related infections in neutropenic patients: a prospective controlled randomized trial using a chlorhexidine and silver sulfadiazine-impregnated central venous catheter.

Antiseptic coating of intravascular catheters may be an effective means of decreasing catheter-related colonization and subsequent infection. The purpose of this study was to assess the efficacy of chlorhexidine and silver sulfadiazine (CH-SS)-impregnated central venous catheters (CVCs) to prevent catheter-related colonization and infection in patients with hematological malignancies who were subjected to intensive chemotherapy and suffered from severe and sustained neutropenia. Proven CVC-related bloodstream infection (BSI) was defined as the isolation of the same species from peripheral blood culture and CVC tip (Maki technique). This randomized, prospective clinical trial was carried out in 106 patients and compared catheter-related colonization and BSI using a CH-SS-impregnated CVC (n=51) to a control arm using a standard uncoated triple-lumen CVC (n=55). Patients were treated for acute leukemia (n=89), non-Hodgkin's lymphoma (n=10), and multiple myeloma (n=7). Study groups were balanced regarding to age, sex, underlying diseases, insertion site, and duration of neutropenia. The CVCs were in situ a mean of 14.3+/-8.2 days (mean+/-SD) in the study group versus 16.6+/-9.7 days in the control arm. Catheter-related colonization was observed less frequently in the study group (five vs nine patients; p=0.035). CVC-related BSI were significantly less frequent in the study group (one vs eight patients; p=0.02). In summary, in patients with severe neutropenia, CH-SS-impregnated CVCs yield a significant antibacterial effect resulting in a significantly lower rate of catheter-related colonization as well as CVC-related BSI.

Bacteremia↗
PubMed2006

Multiple exposures to chlorhexidine and xylitol: adhesion and biofilm formation by Streptococcus mutans.

Growing evidence from clinical studies suggests that mothers using xylitol gums or lozenges have decreased levels of Streptococcus mutans (SM) and do not transmit these cariogenic bacteria as readily to their children. To begin to determine mechanisms for these clinical findings and to explore potential synergism of antimicrobial combinations, we studied the effect of multiple exposures of chlorhexidine (CHX) combined with copper gluconate (CG) or zinc gluconate (ZG) followed by xylitol (XYL) on the ability of SM to adhere and form biofilms. Cell suspensions of SM were exposed two times to CHX; CG; CHX plus CG; ZG; and CHX plus ZG, and then four times to XYL. Control cells were exposed six times to water or XYL or received no treatment. For biofilm assessment, glass slides were inoculated with treated cells, and numbers of bacteria were enumerated after 48 hours of incubation. To assess the ability of SM to adhere, microtiter plate wells coated with primary S. sanguinis biofilms grown in sucrose were inoculated with treated SM, and adhesion was determined. Cells exposed to CHX-XYL combinations exhibited significant but transient inhibition of growth. The multiple-exposure regimen groups showed significant decreases in the ability of SM to form biofilms (P < 0.05). However, the CHX-XYL group exhibited a much greater effect than the other treatment groups (P < 0.001). Adhesion studies revealed that none of the multiple-exposure regimens had a significant effect on adhesion of SM to primary biofilms of S. sanguinis. We concluded that significant inhibition of SM growth and subsequent inability to grow as biofilms in the presence of sucrose occurs after a staggered exposure regimen to CHX initially and then to XYL. This may help explain the clinical data showing the decreased levels of SM in mothers treated with CHX and XYL.

Anti-Infective Agents, Local↗