Blood Concentrations of Chlorhexidine in Hospitalized Children Undergoing Daily Chlorhexidine Bathing

Abstract

We collected serial blood samples from children in the intensive care unit who underwent daily bathing with 2% chlorhexidine gluconate (CHG)-impregnated cloths. Low concentrations of CHG were detected in a few blood samples, indicating absorption through intact skin. There was no suggestion that CHG accumulated in the blood with repeated exposures.

Safety of chlorhexidine gluconate used for skin antisepsis in the preterm infant

“…Future studies should also evaluate the potential for accumulation of chlorhexidine in the blood with repeated exposure, which has been suggested in preterm neonates 7 but not found in older infants and children. 40 There are many NICUs across the US routinely using CHG in preterm infants, a population in which the US FDA (Food and Drug Administration) has not approved its use. Although there may be antiseptic benefits of CHG use in this population, more data on these vulnerable, high-risk preterm infants are needed to establish safety or warn of potential toxicity.…”

Chlorhexidine Bathing in a Tertiary Care Neonatal Intensive Care Unit: Impact on Central Line–Associated Bloodstream Infections

“…29 In children aged greater than 3 months, CHG blood level was detected after CHG bathing in 1 of 12 (8.3%) children enrolled, at a concentration of 57 jtfg/L, with no evidence of CHG accumulation. 30 A study of neonatal rhesus monkeys washed daily with CHG did not show any absorption through the skin, even after repeated washing with an 8% CHG solution for 90 days. 31 Despite extensive use and evidence that some absorption occurs, CHG has not been associated thus far with any documented neurological adverse event, except when instilled directly in the middle ear.…”

Effect of aqueous chlorhexidine on skin colonization with gram negative bacteria in preterm infants admitted in NICU: a blinded RCT

“…There are no established values for what a safe concentration of chlorhexidine in the blood is. 15,8,19,20 However, we limited our applications to three in the study since the much-feared neurotoxicity in the hexachlorophene usage through systemic absorption from the skin was reported after four or more applications. 21 The alcohol that is known to potentiate the absorption of topically applied chlorhexidine was also avoided in present study.…”