Chlorhexidine Gluconate & Cetrimide

Chlorhexidine gluconate and cetrimide are two important antiseptics or chemical compounds that kill microorganisms on the skin and the mucocutaneous tissues such as the mouth. Both of these chemicals may be used alone or in combination with other substances to control microbes and to prevent human disease.

Antiseptic Eary History

Bacterial cells are small and dangerous.

Phenol was first used as an antiseptic for surgical operations in patients with fractures, especially compound fractures. Phenol was sprayed on the skin and in the air to prevent microbes in the environment from invading the skin and deeper tissues. Phenol was effective but harsh to the skin.

Benefits of Chlorhexidine and Cetrimide

Both chlorhexidine and cetrimide, two newer antiseptics, are relatively non-toxic when used on the skin or mucocutaneous membranes. In contrast to phenol, they each can be used more often and with no harmful effects when they are applied to these tissue sites. Each compound directly damages, injures and kills many potential pathogens without injuring the skin or the mucous membranes. Further, each compound has a residual, or remainder effect, that promotes continued inhibition of any new microbial growth.

Chemical Action of Antiseptics

IV lines carry vital fluids past the skin to veins.

Both antiseptics react strongly and effectively with cell membranes, enzymes and critical cell proteins. The antiseptics change, alter and destroy the shape, structure and functions of many different proteins vital for the microbial cell activity. This actions occurs within a few seconds to a few minutes. The injury and death of the microbes serves to protect the human who uses or receives the compound topically.

Chlorhexidine Oral Prophylaxis in Cancer Patients

Prophylactic use of chlorhexidine mouthrinses in cancer patients (undergoing chemotherapy) reduces oral mucositis and microbial burdens. Although some increases in gram-negative bacilli may occur in the chlorhexidine-treated cancer patients undergoing therapies, there seems to be no evidence of increase in any systemic infections in these treated patients.

Chlorhexidine and IV Catheters

Pediatric researchers Garland et al., studied neonates and determined that 0.5% chlorhexidine gluconate in 70% isopropyl alcohol was better than 10% povidone-iodine for the prevention of microbial colonization of peripheral intravenous catheters in neonates. This finding is important because many hospitals use iodine for skin disinfection and believe it is the best antiseptic available for catheter sites.

Cetrimide Warning

The benefits of chlorhexidine are well documented by research studies done on healthy and compromised humans and indicates it is more effective than cetrimide. Cetrimide is a quaternary ammonium compound that some gram-negative bacteria can become resistant to. Careful, selected and proper use of antiseptics can protect and promote good patient and personal health.

References

• Pub Med: Chlorhexidine Prophylaxis for Chemotherapy- and Radiotherapy-Induced Stomatitis
• CDC: Guideline for Hand Hygiene in Health-Care Settings
• Pub Med: Comparison of 10% Povidone-Iodine and 0.5% Chlorhexidine Gluconate for the Prevention of Peripheral Intravenous Catheter Colonization in Neonates