A review of the effectiveness and uses of chlorhexidine
Chlorhexidine is a biguanide compound with antimicrobial ability, which is used against a wide range of pathogens in many antiseptic products as an active ingredient or as a long-lasting antiseptic agent along with other compounds. Chlorhexidine in antiseptic products does not have any corrosive properties. In the figure below, you can see the chemical structure of chlorhexidine:
Mechanism of action
Chlorhexidine in the composition of skin and mucous products is usually used in concentrations higher than 0.05% (500 µg/mL) and can be used in a variety of water and alcohol based solutions and due to its high compatibility with many compounds Like quaternary ammonium compounds, it is widely used together with other substances in the formulation of antiseptics.
In concentrations lower than the lethal limit, chlorhexidine as a bacteriostatic agent causes damage to the pathogen by disrupting the ion balance on the surface of the pathogen’s membrane and damaging it and leaking ions, and in lethal concentrations it causes coagulation of the pathogen’s cytoplasmic proteins. and causes its death.
Chlorhexidine is effective against a wide range of Gram-positive and Gram-negative bacteria, yeasts (such as Candida albicans and dermatophytes) and enveloped viruses (such as influenza, herpes and HIV). The antimicrobial effectiveness of chlorhexidine starts about 20 seconds after consumption, and due to the temporary establishment and adhesion of the chlorhexidine molecule on the skin, the effectiveness increases continuously over time.
Areas of application of chlorhexidine
Chlorhexidine is used as an effective ingredient in the composition of antiseptics for various applications. In the official pharmacopoeia of the Ministry of Health, Treatment and Medical Education, compounds containing chlorhexidine are also mentioned. Some of the uses of chlorhexidine in the composition of antiseptics can be summarized as follows:
- Effective substance and long-acting disinfectant in the composition of sanitary napkins
- Effective substance and long-acting disinfectant in the composition of surgical dressings
- Skin disinfection of the entire body surface before surgery
- Preparation and disinfection of the skin at the surgical site
- Antiseptic products in the care of all types of vascular catheters in order to prevent infection
- Antiseptic products for the care of urinary catheters
- Prevention of wound infection
- Anti-plaque agent in the composition of mouthwash to prevent infection after oral and dental surgery
Apart from these cases, one of the fields of application of chlorhexidine is antiseptic compounds in the field of gynecology and obstetrics. Unlike compounds such as iodized compounds such as betadine, one of the important comparative advantages of chlorhexidine is its lack of inactivation in the presence of blood and other organic compounds, which gives it a special advantage for use in the field of gynecology and obstetrics.
side effects
The side effects of exposure to chlorhexidine have been repeatedly investigated in extensive human studies and clinical trials in patients, medical staff and the general public. The results of these studies show that the absorption of chlorhexidine caused by application on the skin surface and even in case of accidental ingestion is negligible.
Also, the results of epidemiological investigations indicate a low prevalence of sensitivity caused by skin and mucosal application of compounds containing chlorhexidine. In addition to these cases, various studies have been conducted on the effect of chlorhexidine on cell death (cytotoxicity) in order to investigate its effect on wound healing, which proves that chlorhexidine does not have a negative effect on wound healing.
Unlike iodine, which shows significant absorption even in a single application and exposure and can cause transient effects in the mother or baby, chlorhexidine does not have significant skin absorption and side effects.
Also, frequent studies have been conducted on the effects of carcinogenesis and mutagenesis after exposure to chlorhexidine. In in vitro studies in the presence or absence of metabolic enzymes, no genotoxic effects of chlorhexidine were reported. Also, the results of frequent investigations have not reported any evidence of chlorhexidine’s carcinogenicity. The International Agency for Research on Cancer affiliated to the World Health Organization (IARC) has not classified chlorhexidine among any of the carcinogenic risk groups. All these cases confirm the very high safety of chlorhexidine in frequent applications with products containing it.