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chlorhexidine

S02AA09

Forms & Strengths

2% aqueous solution for skin prep
0.05% ophthalmic solution
0.12% oral rinse
0.05% wound cleanser
2% catheter lock solution
0.5% antiseptic wipes

Adult Dosing

Skin prep: apply 2% solution to intact skin, let dry 3 min before incision
Surgical hand scrub: 2% solution, scrub 2-5 min, rinse
Ophthalmic: 1 drop 0.05% solution q.i.d. or as directed
Oral rinse: 15 mL 0.12% solution, swish 30 s, spit, 2×/day
Wound irrigation: 0.05% solution, irrigate 10‑20 mL per cm²
Catheter lock: 2% solution, 0.5 mL per lumen, dwell 30‑60 min

Pediatric Dosing

Skin prep: 2% solution, apply thin layer, do not exceed 10 mL total
Ophthalmic: 0.05% solution, 1 drop q.i.d. for infants, adjust per weight
Oral rinse: not for children <6 y; if used, 5 mL 0.12% solution, swish 30 s, spit, once daily
Wound cleansing: 0.05% solution, irrigate with 5‑10 mL per cm²
Catheter lock: 2% solution, 0.1‑0.2 mL per lumen, dwell ≤30 min

Indications

Pre‑operative skin antisepsis
Surgical hand hygiene
Ophthalmic antiseptic (conjunctival prep)
Oral rinse for gingivitis/periodontitis
Wound and burn cleansing
Catheter lumen lock solution
Diaper‑rash prevention

Mechanism of Action

Cationic bisbiguanide binds to negatively charged bacterial cell walls
Disrupts membrane integrity and precipitates cytoplasmic contents
Broad‑spectrum bactericidal (Gram‑+, Gram‑‑), fungistatic, limited virucidal activity

Contraindications

Known hypersensitivity to chlorhexidine or related compounds
Severe burns >30% body surface area
Use in ear canal or middle ear
Neonates <1 month for catheter lock or eye use

Adverse Reactions

Local skin irritation, burning, itching
Contact dermatitis, urticaria, rare anaphylaxis
Ocular irritation or corneal staining
Taste alteration and tooth staining with oral rinse
Rare ototoxicity if introduced into ear

Drug Interactions

Reduced activity with anionic surfactants (e.g., soaps, povidone‑iodine)
Organic material (blood, pus) diminishes efficacy
Potential cross‑reactivity with latex products in sensitized patients
Concurrent use with other antiseptics may increase local irritation

Curated Content: Needs Vetting Before Put to Clinical Use