Chlorhexidine gluconate is a disinfectant and antiseptic that is used for skin disinfection before surgery and to sterilize surgical instruments.

It may be used both to disinfect the hands of the healthcare providers.

Has efficacy against a range of microorganisms, but does not inactivate spores.

Chlorhexidine salts dissociate and release the positively charged chlorhexidine cation.

The binding of this cationic molecule to negatively charged bacterial cell walls, results at low concentrations of chlorhexidine in a bacteriostatic effect, and at high concentrations in membrane disruption results in cell death.

Other uses include: cleaning wounds, preventing dental plaque, treating yeast infections of the mouth, and to keep urinary catheters from blocking.

It is used in disinfectants of the skin and hands, cosmetics, creams, toothpaste, deodorants, antiperspirants, and pharmaceutical products as a preservative in eye drops, active substance in wound dressings, antiseptic mouthwashes, root canal irrigation and as an intracanal dressings.

It is available as a liquid or powder.

Pregnancy category US: B (No risk in non-human studies)

Routes of administration are topical, and mouth wash.

The reason for chlorhexidine’s effectiveness is that it strongly adheres to surfaces in the mouth and thus remains present in effective concentrations for many hours.

Side effects include: skin irritation, teeth discoloration, allergic reactions, and eye irritation with contact.

Use in pregnancy appears to be safe.

Evidence suggested to be more effective than povidone-iodine.

It is an effective antimicrobial against Gram-positive and Gram-negative organisms, facultative anaerobes, aerobes, and yeasts.

It is particularly effective against Gram-positive bacteria.

It is ineffective against viruses.

Similar to other cation-active compounds, it remains on the skin.

When used as a mouthwash with dental healthcare, it can reduce plaque build up and improve mild gingivitis.

Chlorhexidine mouthwash adverse effects including damage to the mouth mucosa, tooth discoloration, tartar build-up, and impaired taste.


Chlorhexidine binds to tannins, so it’s  prolonged use in persons who consume coffee, tea or red wine is associated with staining of teeth, and can also cause taste disturbance or alteration.

Chlorhexidine digluconate is a chemical antiseptic and is used in a 0.12–0.2% solution as a mouthwash.

To enhance the antiplaque effect of chlorhexidine, the interval between toothbrushing and rinsing with CHX should be be more than 30 minutes-2 hours after brushing

Chlorhexidine skin or cord care can reduce the incidence of omphalitis by 50% and also neonatal mortality by 12%.

It is used as a skin cleanser for surgical scrubs, a cleanser for skin wounds, for preoperative skin preparation and germicidal hand rinses.

It is ototoxic, and if placed in the ear canal which has a ruptured eardrum, it can lead to deafness.

The Federal Drug Administration recommendation is to limit the use of a chlorhexidine gluconate mouthwash to a maximum of six months, to prevent carcinogenicity.

It is poorly absorbed into gastrointestinal tract.

If aspirated can cause of acute respiratory distress syndrome.

Daily bathing with chlorhexidine impregnated washcloths reduces the risk of acquisition of multi drug resistant organisms and the development of hospital acquired bloodstream infections (Climo MW et al).

Daily bathing with chlorhexidine decreases skin colonization with multi drug-resistant organisms, decreases the rates of bloodstream infections and reduces Clostridia difficile infections.

Chlorhexidine is a broad-spectrum topical antimicrobial agent that may decrease the bacterial burden, reducing infections when used to bathe the skin.

In a pragmatic cluster randomized, crossover study of 9340 patients admitted to intensive care units, daily bathing with chlorhexidine did not reduce the incidence of healthcare-associated infections including: hospital acquired central line bloodstream infections, catheter associated urinary tract infections, ventilator associated pneumonia or C. difficile (Noto MJ et all).

The above study does not support daily bathing of critically ill patients with chlorhexidine.

Leave a Reply

Your email address will not be published. Required fields are marked *