Anaphylactic symptoms due to chlorhexidine gluconate

Okano, M.

doi:10.1001/archderm.125.1.50

Cited by 145 publications

(71 citation statements)

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“…The results obtained in this prospective study agree with previously reported data, both as concerns patient skin disinfection and the type of bacterial strains isolated [17], while differing considerably in the quantity found, which in the literature does not exceed 9%, in spite of the fact that scrubbing time was increased by 1 min with respect to American APIC (Association for Professionals in Infection Control and Epidemiology 1995) standards.…”

Section: Discussionsupporting

confidence: 89%

Are surgical scrubbing and pre-operative disinfection of the skin in orthopaedic surgery reliable?

Salvi

Chelo

Caputo

et al. 2005

Knee Surg Sports Traumatol Arthrosc

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This study attempts to establish the actual effectiveness of pre-surgical disinfection of the patient and surgeon's hands. We evaluated bacterial density and composition on the skin of 15 patients undergoing knee arthroscopy and the left hand of two surgeons after standard disinfection with povidone-iodine. Three samples were taken after the first 6-min scrub in the first surgical operation from the periungual space of the 1 degrees finger, from the interdigital space between the 2 degrees and 3 degrees fingers and from the transverse palmar crest of the left hand of two surgeons for seven consecutive surgical sessions, for a total of 42 samples, and two samples from the pre-patellar skin and from the popliteal skin of 15 patients undergoing knee arthroscopy, for a total of 30 samples. Pre-surgical handwashing and disinfection procedures were identical in each case. Pre-surgical disinfection of the patient's skin with povidone-iodine was shown to be completely effective, with 100% of samples negative. Samples taken from the interdigital space and the palmar crest (100% of samples negative) demonstrated the efficacy of disinfection of the surgeon's hands with povidone-iodine, while the periungual space was contaminated in 50% of the samples. The bacterial strains isolated belong to the staphylococcus genus in 100% of the cases, with pathogenic strains in 29.6% of the cases. Standard pre-surgical disinfection of skin in areas easily accessible to the disinfectant is sufficient in itself to guarantee thorough sanitization. Standard scrubbing of the surgeon's hands is insufficient in eliminating bacterial contamination, including pathogenic germs, in the periungual space, where it is probably difficult for the disinfectant to come into contact with the skin.

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Section: Discussionsupporting

confidence: 89%

Are surgical scrubbing and pre-operative disinfection of the skin in orthopaedic surgery reliable?

Salvi

Chelo

Caputo

et al. 2005

Knee Surg Sports Traumatol Arthrosc

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“…We actually did not expect that CHG would demonstrate bactericidal effects at such a low concentration when employed in the present experimental series. In Japan, the use of chlorhexidine is limited because it has caused allergic reactions and anaphylactic shock in some patients [28]. Because of this, only very low concentrations of CHG are permitted for homecare use, and all types of chlorhexidine-containing anti-bacterial agents are used with maximum caution [29].…”

Section: Discussionmentioning

confidence: 99%

Potentials of Mouthwashes in Disinfecting Cariogenic Bacteria and Biofilms Leading to Inhibition of Caries

Oyanagi¹,

Tagami²,

Matin³

2012

TODENTJ

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Objectives:The aim of this study was to compare the effects of certain commercially available mouthwashes on cariogenic bacteria and biofilms, following the acquisition of inhibition potentials of caries.Materials and Methods:Mouthwashes containing I) chlorhexidine gluconate (CHG; 0.0005% w/v), II) benzethonium chloride (BTC; 0.01% w/v), III) an essential oil (Listerine), and IV) povidone-iodine (PVP-I; 0.035% w/v) were tested on planktonic cariogenic bacteria, biofilms, and an ex vivo caries model. Bacterial aliquots were inoculated with each solution separately and vortexed for 10 seconds at room temperature. Bacterial viability was subsequently investigated by fluorescence microscopy (FM) after staining with a BacLight viability kit and the number of colony-forming units (CFUs) was counted. Similarly, mouthwash solutions were applied to artificial cariogenic biofilms, and bacterial viability of the biofilms was investigated as stated above. Inhibition potentials of two selected mouthwashes of carious lesions were investigated using biofilm-induced caries and a secondary caries model. In all steps, a phosphate-buffered saline (PBS) solution was included as a control.Results:Planktonic cariogenic bacteria and bacteria embedded in biofilms were killed in remarkably large numbers with Listerine and PVP-I treatment compared to PBS and other gargles. CFU counts also showed significant reduction after treatment with Listerine and PVP-I compared to other solutions (P<0.05). Listerine also displayed significant (P<0.05) inhibition effects in preventing the progression of demineralization.Conclusion:Bactericidal potencies of the mouthwashes varied significantly, suggesting that mouthwashes like Listerine can be useful for the prevention of caries and secondary caries.

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“…A previous study reported specific IgE antibodies to chlorhexidine (9). There are several reports that patients with prior sensitization to chlorhexidine and with relatively mild contact dermatitis may be at increased risk of severe immediate-type reactions (10, 11). …”

Section: Discussionmentioning

confidence: 99%

A Case of Anaphylaxis to Chlorhexidine during Digital Rectal Examination

et al. 2008

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Chlorhexidine is widely used as an antiseptic and disinfectant in medical and non-medical environments. Although the sensitization rate seems to be low, its ubiquitous use raises the possibility of sensitization in many patients and medical care workers. We describe a patient with anaphylaxis during digital rectal examination with chlorhexidine jelly. Urticaria, angioedema, dyspnea, and hypotension developed within a few minutes of the rectal examination. The patient fully recovered after treatment with epinephrine and corticosteroids. Skin tests for chlorhexidine were undertaken 5 weeks later, showing positive prick and intradermal skin tests. Within 30 min of the skin test, the patient complained of febrile sensation, chest tightness, angioedema, and urticaria on the face and trunk. An enzyme allergosorbent test for latex was negative. We present this case to alert clinicians about hypersensitivity to chlorhexidine that could potentially be life-threatening. We suggest that chlorhexidine should be recognized as a causative agent of anaphylaxis during procedural interventions.

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Anaphylactic symptoms due to chlorhexidine gluconate

Cited by 145 publications

References 0 publications

Are surgical scrubbing and pre-operative disinfection of the skin in orthopaedic surgery reliable?

Are surgical scrubbing and pre-operative disinfection of the skin in orthopaedic surgery reliable?

Potentials of Mouthwashes in Disinfecting Cariogenic Bacteria and Biofilms Leading to Inhibition of Caries

A Case of Anaphylaxis to Chlorhexidine during Digital Rectal Examination

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