What is Chlorhexidine?
Chlorhexidine is an antiseptic agent. This differs from an antibiotic which targets only specific classes of bacteria. Chlorhexidine would fall into a similar category of antiseptic agents such as bleach. Unlike bleach, chlorhexidine is safe to use on the skin and other bodily surfaces.
How is it used commercially?
Chlorhexidine has been used commercially for almost 60 years and is available in more than 60 medical products. It is commercially available for use in both a hospital environment and for public use.
How is it used in the hospital?
Hospitals use chlorhexidine as a key tool to protect patients against infections and prevent the spread of organisms like Methicillin-resistant Staphylococcus aureus (MRSA). It is used in different products related to skin care (patient preoperative scrubs or showers), hand hygiene (soaps), vascular access (catheter end caps, skin preps, dressings), ventilator oral care and urology. It is probable that if you or a loved one is admitted to the hospital, you or they will be treated with chlorhexidine.
How is it used outside the hospital?
You or a loved one may have been prescribed a mouthwash or toothpaste by a dentist. Chlorhexidine is a common ingredient in mouthwashes or toothpastes used to treat gingivitis or keep the mouth clean. Many people are prescribed a chlorhexidine mouthwash after having wisdom teeth removed, major oral surgery or to treat other dental issues. Another common use of chlorhexidine may be as a skin or cosmetic product. These are often used as hand sanitizers, shampoos or skin creams.
Outside the hospital, there is frequent use of chlorhexidine in the vascular access products mentioned above. Vascular access procedures can increase the risk of infection because the natural barrier of the skin is not intact and chlorhexidine is used to protect against infection in this area. A chlorhexidine-treated PICC is available for outpatient vascular access to reduce microbial growth on the inside and outside of the PICC.
The chlorhexidine-treated PICC is also indicated to reduce thrombus accumulation (clotting on the catheter). Chlorhexidine valves are available to protect against infection at the medication access point. Chlorhexidine sponge dressings are used to protect against skin infections. Chlorhexidine skin cleanser is used during bandaging to protect against infections during dressing changes.
Another common use of chlorhexidine at home is chlorhexidine bathing. If you or a loved one is undergoing a surgical procedure, you/they may be encouraged to bathe or shower with chlorhexidine prior to the procedure to prevent infections caused by the surgery.
How effective is chlorhexidine?
In many ways, chlorhexidine is effective like antibiotics against bacteria, but unlike an antibiotic it is also effective against virtually all bacteria and fungi. It does not work quite as fast as alcohol for disinfecting, but it works in 20 seconds and lasts much longer.1 For this reason, it is often used in combination with alcohol in skin preparation. In medical devices, chlorhexidine has been shown to be a long lasting and an effective means to reduce infection.
Is there risk of resistance to chlorhexidine?
Due to the way chlorhexidine works at the microbiology level, organisms are unlikely to build up resistance to chlorhexidine like they would to an antibiotic. Chlorhexidine works universally against all types of bacteria and fungus to burst the cell wall and kill the cell. Over the past 60 years, no chlorhexidine resistant organisms, such as MRSA or VRE, have appeared in a clinical setting.
How can you ensure you are receiving the best care?
Chlorhexidine is one of the many antimicrobial tools available in healthcare treatment. You have an important role in preventing infection whether you are the patient or the patient's friend/family member. Asking questions of healthcare personnel can help them make the best decisions, follow best practice, and include you in the process. In this process, you can ask whether a chlorhexidine option exists for a specific treatment or procedure. If you or someone else receives a chlorhexidine treatment, be sure to ask about the treatment and proper use.
How can I help ensure that chlorhexidine is used safely?
Although reactions to chlorhexidine are rare, they can happen. It is important that you report any changes you or someone else might be experiencing. For example, if you experience skin irritations or redness, relay the information to a healthcare worker.