chlorhexidine gluconate solution: clinical use

Prescribing considerations

• Confirm the intended product and route because chlorhexidine formulations have different uses.
• Review previous unexplained peri-procedural allergy because chlorhexidine may be present in medicines and medical devices.
• Prevent ocular exposure, particularly around the head or face and in patients unable to report exposure.
• Use cautiously on leg ulcers or stasis dermatitis because sensitisation may be more frequent.
• Counsel about slipping and the fire risk from contaminated fabrics.

Contraindications and cautions

• Known hypersensitivity to chlorhexidine or another product component
• Possible history of chlorhexidine-related allergic reaction

Monitoring

• Assess persistent or worsening dermatitis, pruritus, erythema, rash, urticaria, irritation or blistering.
• Treat suspected immediate hypersensitivity as a medical emergency and record chlorhexidine allergy clearly.
• After ocular exposure, rinse immediately and obtain ophthalmology advice, especially with symptoms or visual change.

Clinical pharmacology

Chlorhexidine is a cationic bis-biguanide antiseptic that binds strongly to skin and tissues and impairs microbial membrane function. Absorption through the skin is considered insignificant.

Formulation and product differences

• The selected products are pourable antimicrobial emollient creams, not oral, wound-irrigation or pre-procedure antiseptic products.
• The cream contains paraffin-based emollients and cetostearyl alcohol, which can cause local contact dermatitis.
• Chlorhexidine gluconate solution is incorporated into the cream base.

Cream

Route: Cutaneous

Strengths: 1%, 1% w/w