cetrimide + chlorhexidine acetate: clinical use

Prescribing considerations

• Confirm that the intended site is suitable for external topical irrigation or licensed swabbing.
• Check for chlorhexidine, cetrimide or excipient hypersensitivity.
• Use extreme care around the face and head to prevent ocular exposure.
• In neonates, particularly premature infants, use only in specialist settings and prevent pooling.
• Inspect the solution and container before use.

Contraindications and cautions

• Known hypersensitivity to chlorhexidine or cetrimide.
• Ocular, oral, intravenous or auditory-canal use, particularly with a perforated eardrum.
• Application near the meninges, brain or spinal cord.

Monitoring

• Observe for immediate hypersensitivity, including bronchospasm, hypotension or collapse.
• After eye exposure, irrigate promptly and arrange ophthalmic assessment.
• Monitor neonatal skin for chemical injury.
• Assess persistent rash, pain or local inflammation.

Clinical pharmacology

Active against a range of vegetative Gram-positive and Gram-negative bacteria, although some Pseudomonas and Proteus species may be less sensitive. Chlorhexidine principally disrupts bacterial membranes; systemic absorption through skin is minimal with topical use.

Formulation and product differences

• This is a sterile, clear yellow aqueous irrigation solution, not an oral, intravenous or alcohol-based preparation.
• It contains Sunset Yellow, which may cause allergic reactions.
• It is supplied in bottles or laminated sachets; avoid prolonged immersion of rubber equipment.
• Soaps, anionic materials and unverified additives are incompatible.