ACTION AND MECHANISM

Antiseptic, chlorophenylbiguanide derivative. It has a relatively broad antibacterial (bacteriostatic) spectrum, with particular activity against Gram-positive bacteria. It is sporostatic. It does not usually induce antimicrobial resistance. It also has fungistatic action (Candida). Its action is relatively slow but has considerable persistence and residual adherence.

SENIORS

No specifically geriatric problems have been described in this age group.

CONTRAINDICATIONS

- Hypersensitivity to the medication.

PREGNANCY

FDA Category B. No fetal risk has been reported in animal studies. There are no adequate and well-controlled human studies. Cautionary statement.

INDICATIONS

-"1%": [DISINFECTION] of wounds, erosions, [BURNS], [BEDSORES], preoperative skin disinfection. Disinfection of the newborn's navel. Barrier against bacterial infection applied to the hands of healthcare personnel (cream).
-"4%": Preoperative hand disinfection in surgery, antiseptic hand washing in hospitals and pre/postoperative skin antisepsis in patients undergoing surgery.
- Spray: Disinfection of minor burns, small superficial wounds, cracks and abrasions.

INTERACTIONS

The action of chlorhexidine is diminished by alkaline pH, the presence of organic matter, anionic detergents, and tannins. Elevated temperature, neutral pH, non-ionic detergents, alcohol, and quaternary ammonium salts enhance its action. It may interfere with microbiological antibiotic assays.

LACTATION

It is unknown whether this medication is excreted in breast milk. No problems have been reported in humans, although the possible risk of systemic effects should be taken into account. Cautionary statement.

CHILDREN

No specifically pediatric problems have been described in this age group.

POSOLOGY

Topical route:
- 1%: Apply undiluted to the surface to be disinfected. No more than two applications per day are recommended. Hand disinfection for healthcare personnel: Pour about 5 ml onto hands, rinse with water, and repeat.
- 4%: Preoperative hand disinfection during surgery: Wet arms and forearms, apply 5 ml and wash for 1 minute, cleaning nails, rinse, then apply another 5 ml for 2 minutes, rinse, and dry. Antiseptic hand wash in hospitals: Wet hands and forearms, apply 5 ml and wash for 1 minute, rinse, and dry. Preoperative skin antisepsis in patients undergoing surgery: The day before, wash with 25 ml starting from the face and working downwards, paying special attention to the areas around the nose, armpits, navel, groin, and perineum. Rinse and repeat with another 25 ml, including the hair. Rinse and dry. Repeat the entire above process the following day. Postoperative skin antisepsis in patients undergoing surgery: starting on day 3 after surgery, wash the entire body, excluding the surgical area, according to the guidelines outlined above.
- Spray: Apply 1-2 times after washing the wound.

PRECAUTIONS

- Do not apply to eyes or ears. In case of accidental application, rinse immediately with plenty of water. - Solutions should be stored in bottles with glass, rubber, or plastic stoppers (avoid cork stoppers). - Dilutions should be renewed weekly. Protect from light and heat. - Needles and syringes that have been in contact with chlorhexidine solutions should be rinsed in sterile water or saline solution before intraspinal use. - Treated clothing should not be washed with bleach or hypochlorites, as this may cause brown discoloration of the fabrics. Instead, use household detergents based on sodium perborate.

ADVERSE REACTIONS

Rarely, [SKIN IRRITATION], [DERMATITIS] or [PHOTOSENSITIVITY REACTIONS], in which case discontinue treatment.

Instilled in the middle ear it can cause [DEAFNESS], so extreme precautions are recommended in case of perforation of the eardrum to avoid damage to the tissues of the inner ear.

There are reported cases of [HEMOLYSIS] after accidental ingestion of chlorhexidine.

COMPOSITION

CHLORHEXIDINE: 10 MILLIGRAMS - DIGLUCONATE