Chlorhexidine: Uses and adverse reactions

Dermatitis

Volumn 24, Issue 3, 2013, Pages 112-118

  Silvestri, Dianne L ^a   McEnery Stonelake, Melissa ^a  

^a UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CHLORHEXIDINE; CHLORHEXIDINE GLUCONATE; MOUTHWASH;

ANAPHYLAXIS; CLEANING; DRUG EXPOSURE; DRUG SAFETY; FIXED DRUG ERUPTION; HAND WASHING; HUMAN; PATCH TEST; PRIORITY JOURNAL; REVIEW; SKIN ALLERGY;

ANAPHYLAXIS; ANTI-INFECTIVE AGENTS, LOCAL; CHLORHEXIDINE; DERMATITIS, ALLERGIC CONTACT; HUMANS;

EID: 84881342453     PISSN: 17103568     EISSN: 21625220     Source Type: Journal    
DOI: 10.1097/DER.0b013e3182905561     Document Type: Review

References (78)

1. Milstone AM, Passaretti CL, Perl TM. Chlorhexidine: expanding the armamentarium for infection control and prevention. Clin Infect Dis 2008; 46:274-281.
2. Knudsen BB, Avnstorp C. Chlorhexidine gluconate and acetate in patch testing. Contact Dermatitis 1991;24:45-49.
3. Goon ATJ, White IR, Rycroft RJG, et al. Allergic contact dermatitis from chlorhexidine. Dermatitis 2004;15:45-47.
4. Lim K-S, Kam PCA. ChlorhexidineVpharmacology and clinical applications. Anaesth Intensive Care 2008;36:502-512.
5. Derde LPG, Dautzenberg MJD, Bonten MJM. Chlorhexidine body washing to control antimicrobial-resistant bacteria in intensive care units: a systematic review. Intensive Care Med 2012;38:931-939.
6. Soofi S, Cousens S, Imdad A, et al. Topical application of chlorhexidine to neonatal umbilical cords for prevention of omphalitis and neonatal mortality in a rural district of Pakistan: a community-based, clusterrandomised trial. Lancet 2012;379:1029-1036.
7. Karki S, Cheng AC. Impact of non-rinse skin cleansing with chlorhexidine gluconate on prevention of healthcare-associated infections and colonization with multi-resistant organisms: a systematic review. J Hosp Infect 2012;82: 71-84.
8. Darouiche RO, Wall MJ Jr, Itani KMF, et al. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N Engl J Med 2010;362:18-26.
9. Chlebicki MP, Safdar N. Topical chlorhexidine for prevention of ventilatorassociated pneumonia: a meta-analysis. Crit Care Med 2007;35:595-602.
10. Davison PG, Loiselle FB, Nickerson D. Survey on current hydrotherapy use among North American burn centers. J Burn Care Res 2010;31:393-399.
11. Achilles SL, Reeves MF. Prevention of infection after induced abortion: release date October 2010: SFP guideline 20102. Contraception 2011;83: 295-309.
12. Evans HL, Dellit TH, Chan J, et al. Effect of chlorhexidine whole-body bathing on hospital-acquired infections among trauma patients. Arch Surg 2010;145:240-246.
13. Jee R, Nel L, Gnanakumaran G, et al. Four cases of anaphylaxis to chlorhexidine impregnated central venous catheters: a case cluster or the tip of the iceberg? Br J Anaesth 2009;103:614-615.
14. Garland JS, Alex CP, Mueller CD, et al. A randomized trial comparing povidone-iodine to a chlorhexidine gluconate-impregnated dressing for prevention of central venous catheter infections in neonates. Pediatrics 2001;107:1431-1436.
15. Ho KM, Litton E. Use of chlorhexidine-impregnated dressing to prevent vascular and epidural catheter colonization and infection: a meta-analysis. J Antimicrob Chemother 2006;58:281-287.
16. Eberhard J, Jepsen S, Jervøe-Storm P-M, et al. Full-mouth disinfection for the treatment of adult chronic periodontitis. Cochrane Database Syst Rev 2008;1:CD004622.
17. Van Strydonck DAC, Slot DE, Van der Velden U, et al. Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: a systematic review. J Clin Periodontol 2012;39: 1042-1055.
18. Kutzscher L. Management of irritant contact dermatitis and peripherally inserted central catheters. Clin J Oncol Nurs 2012;16:E48-E55.
19. Abeck D, Brockow K, Mempel M, et al. Treatment of acute exacerbated atopic eczema with emollient-antiseptic preparations using the "wet wrap" ("wet pajama") technique. Hautarzt 1999;50:418-421.
20. Gelmetti C. Skin cleansing in children. J Eur Acad Dermatol Venereol 2001;15(Suppl 1):12-15.
21. Sato K, Kusaka Y, Suganuma N, et al. Occupational allergy in medical doctors. J Occup Health 2004;46:165-170.
22. Hasan T, Rantanen T, Alanko K, et al. Patch test reactions to cosmetic allergens in 1995-1997 and 2000-2002 in FinlandVa multicentre study. Contact Dermatitis 2005;53:40-45.
23. Osmundsen PE. Contact dermatitis to chlorhexidine. Contact Dermatitis 1982;8:81-83.
24. Bechgaard E, Ploug E, Hjorth N. Contact sensitivity to chlorhexidine? Contact Dermatitis 1985;13:53-55.
25. Lasthein Andersen B, Brandrup F. Contact dermatitis from chlorhexidine. Contact Dermatitis 1985;13:307-309.
26. Bajaj AK, Gupta SC. Contact hypersensitivity to topical antibacterial agents. Int J Dermatol 1986;25:103-105.
27. Perrenoud D, Bircher A, Hunziker T, et al. Frequency of sensitization to 13 common preservatives in Switzerland. Swiss Contact Dermatitis Research Group. Contact Dermatitis 1994;30:276-279.
28. Mailhol C, Lauwers-Cances V, Rancé F, et al. Prevalence and risk factors for allergic contact dermatitis to topical treatment in atopic dermatitis: a study in 641 children. Allergy 2009;64:801-806.
29. De Waard-van der Spek FB, Oranje AP. Allergic contact dermatitis to chlorhexidine and para-amino compounds in a 4-year-old boy: a very rare observation. Contact Dermatitis 2008;58:239-241.
30. Le Corre Y, Barbarot S, Frot AS, et al. Allergic contact dermatitis to chlorhexidine in a very young child. Pediatr Dermatol 2010;27:485-487.
31. Liippo J, Kousa P, Lammintausta K. The relevance of chlorhexidine contact allergy. Contact Dermatitis 2011;64:229-234.
32. Calnan CD. Contact dermatitis from drugs. Proc R Soc Med 1962;55:39-42.
33. Wahlberg JE, Wennersten G. Hypersensitivity and photosensitivity to chlorhexidine. Dermatologica 1971;143:376-379.
34. Ljunggren B, Möller H. Eczematous contact allergy to chlorhexidine. Acta Derm Venereol 1972;52:308-310.
35. Roberts DL, Summerly R, Byrne JP. Contact dermatitis due to the constituents of Hibiscrub. Contact Dermatitis 1981;7:326-328.
36. Shoji A. Contact dermatitis from chlorhexidine. Contact Dermatitis 1983;9:156.
37. Bergqvist-Karlsson A. Delayed and immediate-type hypersensitivity to chlorhexidine. Contact Dermatitis 1988;18:84-88.
38. Reynolds NJ, Harman RR. Allergic contact dermatitis from chlorhexidine diacetate in a skin swab. Contact Dermatitis 1990;22:103-104.
39. Rapaport M. Contact dermatitis secondary to chlorhexidine in contact lens cleansing solutions. Am J Contact Derm 1991;2:65-66.
40. Ebo DG, Stevens WJ, Bridts CH, et al. Contact allergic dermatitis and lifethreatening anaphylaxis to chlorhexidine. J Allergy Clin Immunol 1998;101: 128-129.
41. Thune P. [Two patients with chlorhexidine allergy-anaphylactic reactions and eczema]. Tidsskr Nor Laegeforen 1998;118:3295-3296.
42. Barrazza V. Connubial allergic contact balanitis due to chlorhexidine. Contact Dermatitis 2001;45:42.
43. Van Ketel WG, Melzer-van Riemsdijk FA. Conjunctivitis due to soft lens solutions. Contact Dermatitis 1980;6:321-324.
44. Rietschel RL, Wilson LA. Ocular inflammation in patients using soft contact lenses. Arch Dermatol 1982;118:147-149.
45. Moghadam BK, Drisko CL, Gier RE. Chlorhexidine mouthwash-induced fixed drug eruption: case report and review of the literature. Oral Surg Oral Med Oral Pathol 1991;71:431-434.
46. Lauerma AI. Simultaneous immediate and delayed hypersensitivity to chlorhexidine digluconate. Contact Dermatitis 2001;44:59.
47. Aalto-Korte K,Mäkinen-Kiljunen S. Symptoms of immediate chlorhexidine hypersensitivity in patients with a positive prick test. Contact Dermatitis 2006;55:173-177.
48. Sharma A, Chopra H. Chlorhexidine urticaria: a rare occurrence with a common mouthwash. Indian J Dent Res 2009;20:377-379.
49. Wong WK, Goh CL, Chan KW. Contact urticaria from chlorhexidine. Contact Dermatitis 1990;22:52.
50. Stables GI, Turner WH, Prescott S, et al. Generalized urticaria after skin cleansing and urethral instillation with chlorhexidine-containing products. Br J Urol 1998;82:756-757.
51. Krautheim AB, Jermann THM, Bircher AJ. Chlorhexidine anaphylaxis: case report and review of the literature. Contact Dermatitis 2004;50:113-116.
52. Ohtoshi T, Yamauchi N, Tadokoro K, et al. IgE antibody-mediated shock reaction caused by topical application of chlorhexidine. Clin Allergy 1986; 16:155-161.
53. Okano M, Nomura M, Hata S, et al. Anaphylactic symptoms due to chlorhexidine gluconate. Arch Dermatol 1989;125:50-52.
54. Torricelli R, Wüthrich B. Life-threatening anaphylactic shock due to skin application of chlorhexidine. Clin Exp Allergy 1996;26:112.
55. Autegarden JE, Pecquet C, Huet S, et al. Anaphylactic shock after application of chlorhexidine to unbroken skin. Contact Dermatitis 1999;40:215.
56. Snellman E, Rantanen T. Severe anaphylaxis after a chlorhexidine bath. J Am Acad Dermatol 1999;40:771-772.
57. Okuda T, Funasaka M, Arimitsu M, et al. [Anaphylactic shock by ophthalmic wash solution containing chlorhexidine]. Masui 1994;43:1352-1355.
58. Ebo DG, Bridts CH, Stevens WJ. Anaphylaxis to an urethral lubricant: chlorhexidine as the "hidden" allergen. Acta Clin Belg 2004;59:358-360.
59. Noel J, Temple A, Laycock GJA. A case report of anaphylaxis to chlorhexidine during urinary catheterisation. Ann R Coll Surg Engl 2012;94:e159-e160.
60. Bae Y-J, Park CS, Lee JK, et al. A case of anaphylaxis to chlorhexidine during digital rectal examination. J Korean Med Sci 2008;23:526-528.
61. Kluger M. Anaphylaxis to chlorhexidine-impregnated central venous catheter. Anaesth Intensive Care 2003;31:697-698.
62. Khoo A, Oziemski P. Chlorhexidine impregnated central venous catheter inducing an anaphylatic shock in the intensive care unit. Heart Lung Circ 2011;20:669-670.
63. Guleri A, Kumar A, Morgan RJM, et al. Anaphylaxis to chlorhexidinecoated central venous catheters: a case series and review of the literature. Surg Infect (Larchmt) 2012;13:171-174.
64. Evans RJ. Acute anaphylaxis due to topical chlorhexidine acetate. BMJ 1992;304:686.
65. Cheung J, O'Leary JJ. Allergic reaction to chlorhexidine in an anaesthetised patient. Anaesth Intensive Care 1985;13:429-430.
66. Center for Devices and Radiological Health. FDA Public Health Notice: Potential hypersensitivity reactions to chlorhexidine-impregnated medical devices. Food and Drug Administration. Available at: http://www.fda.gov/ medicaldevices/safety/alertsandnotices/publichealthnotifications/UCM062306. Published March 11, 1998. Accessed June 29, 2012.
67. Thong BY-H, Yeow-Chan. Anaphylaxis during surgical and interventional procedures. Ann Allergy Asthma Immunol 2004;92:619-628.
68. Nishioka K, Doi T, Katayama I. Histamine release in contact urticaria. Contact Dermatitis 1984;11:191.
69. Garvey LH, Krøigaard M, Poulsen LK, et al. IgE-mediated allergy to chlorhexidine. J Allergy Clin Immunol 2007;120:409-415.
70. Sivathasan N, Goodfellow PB. Skin cleansers: the risks of chlorhexidine. J Clin Pharmacol 2011;51:785-786.
71. Sijbesma T, Röckmann H, Van der Weegen W. Severe anaphylactic reaction to chlorhexidine during total hip arthroplasty surgery: a case report. Hip Int 2011;21:630-632.
72. Chisholm DG, Calder I, Peterson D, et al. Intranasal chlorhexidine resulting in anaphylactic circulatory arrest. BMJ 1997;315:785.
73. Thong CL, Lambros M, Stewart MG, et al. An unexpected cause of an acute hypersensitivity reaction during recovery from anaesthesia. Anaesth Intensive Care 2005;33:521-524.
74. Parkes AW, Harper N, Herwadkar A, et al. Anaphylaxis to the chlorhexidine component of Instillagel: a case series. Br J Anaesth 2009;102:65-68.
75. Garvey LH, Roed-Petersen J, Husum B. Anaphylactic reactions in anaesthetised patients - four cases of chlorhexidine allergy. Acta Anaesthesiol Scand 2001; 45:1290-1294.
76. ENVIRONMENTAL WORKING GROUP [database online]. Available at: http://www.ewg.org/skindeep/search.php?query=chlorhexidine&h=Go. Accessed October 2, 2012.
77. Lee J, Warshaw E, Zirwas MJ. Allergens in the American Contact Dermatitis Society Core Series. Clin Dermatol 2011;29:266-272.
78. McEnery-Stonelake M, Silvestri DL. Allergic contact dermatitis to chlorhexidine after oral sensitization. Dermatitis 2013;24:92-93.