Pharmacology

Chlorhexidine

Chlorhexidine gluconate (CHG) is an antiseptic solution found in everything from the mouthwash patients receive while on mechanical ventilation to Tegaderm CHG dressings and Biopatches to cover everything from arterial lines to peripheral ECMO cannulas. Let’s certainly not forget about the CHG bath done before surgery!

CHG provides rapid and effectively bacteriocidal AND bacteriostatic properties against gram-positive and gram-negative bacteria in addition to fungi and even enveloped viruses (in vitro). CHG relies on electrostatic attraction to bind the negatively charged regions on bacterial and fungal cell walls as a positively charged molecule. CHG destabilizes the cell wall and ultimately damages cytoplasmic membranes leading to cell death. The topical application binds to surface proteins found on the skin and mucous membranes allowing for prolonged antimicrobial effects (i.e., ~48 hours on the skin).

When cleansing the head/neck region, be very careful about CHG dripping into the ear canal. This medication is ototoxic, and if your patient has a ruptured tympanic membrane, it can lead to deafness!

In what applications have you seen CHG used? Drop me a comment below with your experience and questions!

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