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Chlorhexidine

Generic Name
Chlorhexidine
Brand Names
Betasept, Hibiclens, Instillagel, Nupro Chlorhexidine, Oris, Oro-Clense, Paroex, Perichlor, Peridex, Periochip, Periogard, Prevora, X-pur
Drug Type
Small Molecule
Chemical Formula
C22H30Cl2N10
CAS Number
55-56-1
Unique Ingredient Identifier
R4KO0DY52L
Background

Chlorhexidine is a broad-spectrum antimicrobial biguanide used as a topical antiseptic and in dental practice for the treatment of inflammatory dental conditions caused by microorganisms. It is one of the most common skin and mucous membrane antiseptic agents in use today. The molecule itself is a cationic bis-guanide consisting of two 4-chlorophenyl rings and two biguanide groups joined by a central hexamethylene chain. Topical chlorhexidine for disinfection, as well as oral rinses for dental use, carries activity against a broad range of pathogens including bacteria, yeasts, and viruses.

Chlorhexidine was developed in the UK by Imperial Chemical Industries in the early 1950s and was introduced to the US in the 1970s. The FDA withdrew its approval for the use of chlorhexidine gluconate topical tincture 0.5%, due to a significant number of reports concerning chemical and thermal burns associated with the use of this product. Other formulations of chlorhexidine continue to be available.

Indication

Chlorhexidine is available over-the-counter in various formulations (e.g. solution, sponge, cloth, swab) as a topical antiseptic to sanitize prior to surgeries and/or medical procedures. Dental formulations, available by prescription only, include an oral rinse indicated for the treatment of gingivitis and a slow-release "chip" which is inserted into periodontal pockets and is indicated for the reduction of pocket depth in adult patients with periodontitis as an adjunct therapy to dental scaling and root planing procedures.

Associated Conditions
Aphthous ulcer, Catarrh of the throat, Chemotherapy Induced Oral Mucositis, Chronic Wounds, Decubitus Ulcer, Dental Cavity, Dysphagia, Eczema infected, Foeter Ex Ore, Gingival Bleeding, Gingival Diseases, Gingivitis, Glossitis, Hoarseness, Infection, Infectious Periodontal Diseases, Injury Throat, Mild to Moderate Inflammatory Reaction of the Oral Cavity, Mild to Moderate Inflammatory Reaction of the Pharynx, Mouth injury, Mucositis, Neurodermatitis, Ocular Inflammation, Ocular Irritation, Oral Aphthous Ulcer, Pain, Periodontitis, Pharyngitis, Plaque, Dental, Postoperative Wound Infection, Purulent Gingivitis, Radiation Mucositis, Red eye, Ringworm, Skin Infections, Sore Throat, Stomatitis, Surgical Wounds, Tissue Damage, Tonsillitis, Ulcers, Leg, Wound Infections, Bacterial skin infections, Dry, cracked skin, Gum pain, Moderate Gingivitis, Oral infections, Oral lesions, Recurrent Oral fungal infection, Severe Gingivitis, Superficial Wounds, Throat disinfection, Tongue inflammation
Associated Therapies
Anesthesia of Mucous Membrane, Antimicrobial Therapy, Contact Lens Care, Disinfection, Disinfection of External Genitalia, Disinfection of the Urethra, Disinfection of the Vaginal Mucosa, Irrigation therapy, Lubrication of the Urethra, Oral Care, Oral Hygiene, Oropharyngeal antisepsis, Promotion of wound healing, Skin disinfection, Surgical Scrubbing, Topical Antisepsis, Urethral Anesthesia, Wound Cleansing, Oral antisepsis, Oral disinfection

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• The MARIPOSA trial demonstrated that amivantamab plus lazertinib significantly improved overall survival (OS) compared to osimertinib in EGFR-mutated non-small cell lung cancer (NSCLC). • The combination therapy showed a 30% reduction in the risk of disease progression or death, with a median progression-free survival (PFS) of 23.7 months versus 16.6 months for osimertinib. • Updated data from the MARIPOSA trial presented at the 2024 IASLC World Conference on Lung Cancer showed a sustained benefit in intracranial PFS with amivantamab plus lazertinib. • Enhanced dermatologic management in the COCOON trial reduced the incidence of skin-related adverse events associated with amivantamab and lazertinib, improving patient quality of life.

Chlorhexidine-Alcohol Not Superior to Povidone-Iodine-Alcohol in Cardiac Surgery

• A large, randomized trial found that chlorhexidine-alcohol was not superior to povidone-iodine-alcohol in reducing reoperation and surgical site infection (SSI) rates after major heart surgery. • The study included over 3,200 patients undergoing cardiac surgery via sternotomy across eight French hospitals, with similar outcomes observed in both antiseptic groups. • No significant differences were found in mediastinitis rates, length of hospital stay, hospital readmission rates, or mortality between the two antiseptic solutions. • These findings challenge current recommendations favoring chlorhexidine-alcohol for surgical site preparation, suggesting povidone-iodine-alcohol is a viable alternative.
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