Drug reference

Chlorhexidine

Antibacterial · Antimicrobial prophylaxis

Also known as Chlorhexidine hydrochloride

AntibacterialAntimicrobial prophylaxis

CDSCO approvedSchedule H1

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

, in breastfeeding women, and in children under 12 years. All

FDA category + note

Mechanism

Chlorhexidine is a cationic biguanide antiseptic that strongly adsorbs to bacterial cell membranes through electrostatic interaction with negatively charged phospholipids, causing leakage of small molecules and precipitation of cytoplasmic proteins. It is most effective against gram-positive cocci with lesser activity against gram-negative rods, and it inhibits spore germination. Unlike iodophors, chlorhexidine retains persistent residual bactericidal activity on skin after application and maintains efficacy in the presence of blood and organic materials.

Indications

Oral hygieneReduction of oral bacteraemiaAcanthamoeba keratitissurgical scrubneonatal bathmouthwashobstetricsgeneral skin antisepticpreventing/treating gingivitisreducing oral infections in immunocompromised patients (including AIDS)Decolonization to eliminate colonization of additional body sites with S. aureusPost-discharge decolonization following S. aureus bacteremiaWashes for recurrent S. aureus infections in the community

Dosing

Adult: (white patches) if the dose is too large for the child’s age (taking into account the ﬂuoride content of the local drinking water and of toothpaste). The risk of osteonecrosis of the jaw is substantially greater for patients receiving intravenous bisphosphonates in the treatment of cancer than for patients receiving oral bisphosphonates for osteoporosis or Paget’s disease.…