Chlorhexidine solution is an antiseptic that is specifically intended for topical use. This drug has pronounced bactericidal (destruction of bacteria) and disinfecting properties. This antiseptic agent exhibits the greatest activity against vegetative forms of gram-positive and gram-negative microorganisms, as well as lipophilic viruses, dermatophytes that cause skin diseases, and yeast. In addition, chlorhexidine solution has a good ability to stop the division and growth of fungi. This product affects bacterial spores only at elevated temperatures. This antiseptic drug exhibits fungistatic activity against trichophytes, which are the causative agents of ringworm, and fungi of the genus Candida.
Features of the composition of the drug
One hundred milliliters of a bactericidal agent such as chlorhexidine solution contains 0.05 grams of 0.05% chlorhexidine bigluconate as an active ingredient. Distilled water acts as an auxiliary ingredient.
Main indications for the use of an antiseptic
The instructions recommend using a chlorhexidine solution mainly for disinfecting the surgical field and treating surgeons' hands, as well as for so-called cold sterilization of necessary surgical instruments. In addition, quite often this antiseptic is prescribed for the treatment of cystitis - inflammation of the bladder. In this case, a chlorhexidine solution is used for rinsing, and it is administered using a special catheter. In addition, this bactericidal drug can be used in obstetric and gynecological practice, for example, during the treatment of bacterial vaginosis and colpitis of various etiologies, to eliminate itching of the vulva. This solution can also be prescribed to prevent infectious diseases that are sexually transmitted (including chlamydia, syphilis, trichomoniasis, genital herpes, ureaplasmosis and gonorrhea). This antiseptic is also actively used to prevent the development of various inflammatory complications before abortion, intrauterine examinations, childbirth, surgical interventions, installation of an intrauterine device, and diathermocoagulation procedures for cervical erosion.
For topical use, a bactericidal solution of chlorhexidine is also prescribed for conditions such as stomatitis, gingivitis, periodontitis, aphthae (superficial ulcerations of the mucous membranes), alveolitis (inflammatory damage to some parts of the respiratory tract) and tonsillitis. In addition, it is actively used to disinfect removable dentures and various work surfaces, equipment and devices (for example, thermometers), the heat treatment of which is extremely undesirable. And finally, this antiseptic is excellent for disinfecting the patient’s skin, burns and incised wounds, as well as for providing the necessary postoperative care for patients in dentistry and ENT departments.
List of the most common contraindications
Experts categorically do not recommend using an aqueous solution of chlorhexidine if a person has increased individual sensitivity to chlorhexidine digluconate, as well as with an acute form of inflammatory skin lesion - dermatitis. In addition, according to the instructions, this bactericidal agent is used with great caution during pregnancy, during the lactation period and in childhood.
List of adverse reactions
The manufacturing company notes that the use of an aqueous solution of chlorhexidine in some groups of patients may provoke the development of dermatitis or the appearance of slight swelling. In addition, as a result of the use of this antiseptic drug, conditions such as dry skin, transient itching and hyperemia (redness of the skin) may occur.
Medicines with fully proven effectiveness, which cause not controversy in the medical community, but awe and awe, are, unfortunately, a very rare occurrence. And this group of unconditional and recognized drugs includes the familiar Chlorhexidine.
Behind the nondescript packaging and low price lies the real leader among antiseptics presented on the shelves of our pharmacies. If domestic brilliant green or, for example, Miramistin, remain exclusively Russian medicines, then Chlorhexidine is a generally recognized drug that is used all over the world.
Let's try to figure out together what is the secret of the popularity of this product. And at the same time, find out all about the pitfalls that may be hidden in the instructions for Chlorhexidine - side effects and possible contraindications.
A long story that has no end
Chlorhexidine has been used for almost 60 years in more than sixty pharmaceutical products. During this time, the medicine has unconditionally proven its effectiveness and safety.
And the beginning was made in the early 50s, when Chlorhexidine bigluconate was synthesized in Manchester, at the Royal Chemical Company, which was developing antimalarial drugs. Already in 1954, the new medicine went on sale as a local antiseptic and disinfectant.
Only more than 20 years later, Chlorhexidine began to be used as a topical oral rinse. It turned out that the drug can prevent the development of periodontal disease. Chlorhexidine still holds its position as an anti-periodontal agent today.
A little later, antiseptics began to be included in lubricants, detergents, toothpastes, and even clothing inserts. In 2012, an antithrombogenic catheter was first introduced, which contained Chlorhexidine both externally and internally.
It seems that the story does not end there - this antiseptic still has many new dosage forms and methods of use ahead. After all, you can’t look for such a station wagon! How does the magic drug work? It's time to get into the details.
>>We recommend: if you are interested in effective methods of getting rid of chronic runny nose, pharyngitis, tonsillitis, bronchitis and persistent colds, then be sure to check out this site page after reading this article. The information is based on the author’s personal experience and has helped many people, we hope it will help you too. Now let's return to the article.<<
Mechanism of action of Chlorhexidine
For microorganisms Chlorhexidine bigluconate - this salt is used as an antiseptic- acts differently, and it depends on the type of microbes.
Bacteria
The positively charged Chlorhexidine molecule binds to the bacterial cell wall, which has a negative charge. As a result, destabilization and damage to the cell wall occurs. Interestingly, this process only takes about 20 seconds.
However, the role of the antiseptic does not end there. The drug penetrates the cell and attacks the internal cytoplasmic membrane of the bacterium, as a result of which the contents simply flow into the cytoplasm. The cell dies. High concentrations of chlorhexidine digluconate may cause hardening or congealing of the cytoplasm.
The effect of the drug on pathogenic and opportunistic fungi is very similar to the effect on bacteria. By destroying the cell wall, the antiseptic penetrates the cytoplasmic membrane of the fungus and irrevocably destroys the cell.
Biofilm
Biofilm is a complex collection of microorganisms growing on a solid organic (such as dental plaque) or inorganic surface. Biofilms are characterized by structural heterogeneity, genetic diversity, and complex interactions within the conglomerate.
The matrix protects the cells within it, which makes biofilm microorganisms particularly resistant to antibacterial drugs. Most antiseptics are unable to act within the complex structure of the biofilm. Chlorhexidine broke out from the orderly row of powerless relatives and proved its exceptional abilities. The drug can prevent the adhesion (sticking) of microorganisms to a solid surface, as a result of which the growth and development of biofilm stops.
Other microorganisms
Unlike many antiseptics, Chlorhexidine solution demonstrates high effectiveness against other microbes, for example, bacterial spores and protozoa. It is assumed that it also acts against viruses covered with an additional shell: herpes simplex virus, HIV, cytomegalovirus, influenza virus. Non-enveloped viruses are resistant to Chlorhexidine. These include ARVI pathogens rotavirus, adenovirus and enteroviruses.
Topical chlorhexidine: the hard work of an antiseptic
When applied externally and locally, Chlorhexidine solution forms complexes with proteins of the upper layer of the epidermis or mucous membranes.
When rinsing the mouth, the drug binds to the proteins of the mucous membrane and the surface of the teeth, after which it is slowly released over a long period of time. Imagine that the antimicrobial activity of an antiseptic lasts for two days! As a result of a long-term antiseptic effect, the number of bacteria in the oral cavity is significantly reduced, which in turn prevents plaque.
Due to its ability to “stick” to soft and hard surfaces and release over a long period of time, Chlorhexidine has become the gold standard in dentistry.
Pharmacokinetic properties
Studies confirm that after rinsing with Chlorhexidine solution, about 30% of the active ingredient is retained in the oral cavity.
The drug is intended exclusively for external and local use. However, if you accidentally swallowed a small amount of antiseptic, you should not call an ambulance and prepare for the worst. The drug is practically not absorbed from the gastrointestinal tract. A person who drinks 300 mg of Chlorhexidine - this is almost 300 ml of a solution that is sold in pharmacies - in the blood plasma after half an hour contains only 0.206 mcg / g of the active substance.
Let us add that it is almost impossible for a person of sober mind and clear memory to take 300 ml of antiseptic on the chest. If for some reason force majeure does occur, nothing bad will happen. Over the next 12 hours, the antiseptic will be completely eliminated from the body.
Activity spectrum
So, let's list the microorganisms that cannot resist the action of the drug. Sensitive microbes include:
- gram-positive microorganisms, including various strains of staphylococcus and streptococcus. The bactericidal effect against gram-positive microorganisms is achieved when exposed to a Chlorhexidine solution at a concentration of less than 1 mg/liter;
- gram-negative microorganisms: Escherichia coli and Haemophilus influenzae, Klebsiella, Legionella, Pseudomonas, Proteus, Enterobacteriaceae, Salmonella, Moraxella and others. The drug is more active against gram-positive microorganisms than against gram-negative ones. The antiseptic concentration sufficient for an antibacterial effect when contaminated with gram-negative bacteria must be at least 73 μg/ml;
- mushrooms;
- enveloped viruses.
The peculiarities of the drug’s action in relation to herpes simplex viruses, HIV, and cytomegalovirus are still being studied.
The drug retains antiseptic properties, although less pronounced, in direct contact with biological fluids, for example, blood or pus. This ability distinguishes Chlorhexidine from most other antiseptics.
Chlorhexidine: use of antiseptic
The scope of Chlorhexidine is not limited to pharmaceuticals. Antiseptic is part of many disinfectants - solutions for treating skin and hands. The cosmetics industry cannot do without the drug. As an antibacterial agent, it is added to toothpastes, deodorants, and antiperspirants. The antiseptic is also included in creams for problem skin, which once again proves the effectiveness of Chlorhexidine as a remedy for acne.
In pharmaceuticals, solutions of Chlorhexidine are used in a concentration of 0.05%, less often - 0.02% as:
- preservative in eye drops;
- active ingredient in dosage forms for local and external use, as well as mouth and throat rinses, suppositories, ointments and solutions.
Chlorhexidine in dentistry: indications
Chlorhexidine digluconate is included in mouth rinse solutions. The main indication of an antiseptic is the treatment and prevention of gingivitis.
Let us remember that gingivitis is an inflammatory disease of the gums, which occurs due to the accumulation of microbial plaque on the teeth and is characterized by redness and swelling of the gums. If left untreated in time, the disease can lead to a complication - periodontitis, which leads to the destruction of the alveolar processes.
Patients who are simultaneously diagnosed with both periodontitis and gingivitis are a special category of dental patients that require complex treatment. In such cases, Chlorhexidine is only one of the drugs in combination therapy, and not the main one.
The antiseptic is also used to treat inflammatory disease of the oral mucosa - stomatitis, including aphthous. Chlorhexidine rinses are often prescribed to prevent infection after tooth extraction and other dental procedures.
Among the indications for rinsing, one cannot fail to note the prevention of dental plaque. Possessing a pronounced antibacterial effect, the drug effectively prevents the formation of plaque and tartar on teeth.
Rules for using Chlorhexidine dental solution
How to properly rinse your mouth with Chlorhexidine? So, the procedure is most effective if it is carried out immediately after preventive teeth cleaning. The antiseptic should be applied twice a day - morning and evening - for 30 seconds. The usual dose is 15 ml of undiluted rinse solution.
Immediately after using Chlorhexidine, you should not drink water, brush your teeth or eat breakfast (lunch or dinner) - you will simply wash off the antiseptic. Be patient for 10–15 minutes, and then safely proceed to normal life.
And one last thing. Despite the safety of the medicine, you should still not drink it. When rinsing, make every effort to ensure that the antiseptic does not enter the gastrointestinal tract.
Mouth rinses: an unsightly side effect
One of the most unpleasant side effects of Chlorhexidine digluconate mouthwash is staining the surface of teeth, dentures, the mouth and the back of the tongue.
It is worth noting that such a manifestation of antiseptic does not await all patients. Clinical trials have shown that the likelihood of any noticeable staining is 56%. Moreover, in 15% of people, the discoloration of teeth and tongue will be quite pronounced. Unfortunately, the color scheme in which tooth enamel and the oral cavity are painted does not leave any reason for much optimism. If you fall into the sensitive 15% group, your teeth will likely turn dark brown to black.
Against the background of such information, the possibility of removing stains left by Chlorhexidine using professional methods looks very comforting. The likelihood and intensity of staining increases when interacting with the dyes of tea or coffee.
Recently, manufacturers have begun to produce rinses with Chlorhexidine, which contain an additional component that reduces the risk of staining oral surfaces. Chelated zinc has this effect.
Unlikely but Possible: Other Side Effects of Chlorhexidine Rinse
Other adverse events after using Chlorhexidine oral solution are quite rare. These include:
- changes in taste sensations, the appearance of a bitter taste;
- short-term burning sensation;
- numbness, dryness or soreness of the mucous membranes of the mouth and tongue;
- increased gum bleeding after a light massage;
- transient toothache, sore gums, or general discomfort and increased sensitivity during the treatment of periodontitis (in 50.7% of patients versus 41.4% when using a placebo drug).
Chlorhexidine in otorhinolaryngology: indications and rules of use
The activity of Chlorhexidine against most gram-positive bacteria and viruses gives grounds for using an antiseptic as a solution for gargling.
Let us recall that most tonsillitis (inflammatory diseases of the tonsils) and pharyngitis (inflammation of the pharyngeal mucosa) are associated with streptococci and viruses and much less often with staphylococci.
For gargling, use 0.02% and 0.05% Chlorhexidine solution. Unfortunately, it is not yet possible to find a special form of the drug for gargling in Russian pharmacies. However, the most common Chlorhexidine for external use, which is easy to buy, is perfect for use in ENT practice.
To gargle, you will need about 20 ml of 0.02% or 10-15 ml of 0.05% antiseptic solution, which must be held in the mouth for at least 45 seconds. After the procedure, you should not drink, eat or brush your teeth for about 20–30 minutes.
The optimal frequency of rinsing with Chlorhexidine is three times a day. If desired, the number of procedures can be increased. The duration of treatment is 5–10 days or more, as long as the need exists. The positive aspects of treating throat with Chlorhexidine include high efficiency, safety and cost-effectiveness.
What is not found in the instructions: Chlorhexidine for inhalation
The use of Chlorhexidine as a solution for inhalation is also very promising, although this indication is not mentioned in the instructions for the drug. The antiseptic can be used in nebulizers. Fine particles of Chlorhexidine, entering the lower respiratory tract, are an excellent prevention of bronchitis and pneumonia - pneumonia. In addition, inhalations with Chlorhexidine can be used as part of a complex treatment of laryngitis (inflammation of the vocal cords), tonsillitis, and tracheitis.
The frequency of procedures, as well as the duration of treatment, can be practically unlimited - the drug is so safe.
Is it worth using Chlorhexidine in the nose?
Wide antiseptic capabilities and popular love give rise to new questions. A favorite medicine that has helped with sore throat and pneumonia, thrush and stomatitis, diaper rash and burns, in the hope of healing from new diseases, they are trying to drip into the ears and nose. Is it possible and beneficial to use Chlorhexidine solution as nasal or ear drops?
20% aqueous solution of chlorhexidine bigluconate; in bottles of 500 ml.
pharmachologic effect
pharmachologic effect- antiseptic.Indications for the drug Chlorhexidine bigluconate
Treatment of the surgical field and the surgeon’s hands; sterilization of surgical instruments, treatment of wounds and burns, lavage of the bladder for cystitis.
Contraindications
Hypersensitivity.
Directions for use and doses
Disinfection of the surgical field - 0.5% solution in 70% ethanol for 5 minutes; hand disinfection - 0.5% solution in 70% ethanol or 1% aqueous solution; antiseptics of wounds and burns - 0.5% aqueous solution; disinfection measures in gynecology and obstetrics - from 0.05 to 0.2% aqueous solution; cystoscopy, bladder lavage - 0.02% sterile aqueous solution; disinfection of the urethra during catheterization - 0.05% sterile solution in glycerin; disinfection of medical instruments - 0.5% solution in 70% ethanol for 5 minutes; sterilization of medical instruments - 0.5% aqueous solution at a temperature of 70 °C for 3 hours.
Storage conditions for the drug Chlorhexidine bigluconate
In a place protected from light, at a temperature of 1-25 °C.Keep out of the reach of children.
Shelf life of the drug Chlorhexidine bigluconate
3 years.Do not use after the expiration date stated on the package.
Instructions for medical use
Chlorhexidine bigluconate
Instructions for medical use - RU No. P N015600/01
Last modified date: 16.04.2004
Dosage form
Concentrate for the preparation of solutions for local and external use.
Compound
Active substance:
Chlorhexidine bigluconate 20 g.
Excipients:
Water up to 100 ml.
Description of the dosage form
Colorless or light yellow transparent liquid.
Pharmacological group
Antiseptic.
Pharmacodynamics
Antiseptic. Depending on the concentration used, it exhibits both bacteriostatic and bactericidal effects. The bacteriological effect of both aqueous and alcoholic working solutions) manifests itself in a concentration of 0.01% or less; bactericidal - in a concentration of more than 0.01% at a temperature of 22 ° C and exposure for 1 minute. Fungicidal effect - at a concentration of 0.05%, at a temperature of 22 ° C and exposure for 10 minutes. Virucidal effect - manifests itself at a concentration of 0.01-1%. Effective against pathogens of sexually transmitted infections - gardnerellosis, genital herpes; gram-positive and gram-negative bacteria - Treponema spp., Neisseria gonorrhoeae, Trichomonas spp., Chlamidia spp., Ureaplasma spp.
Does not affect acid-resistant forms of bacteria, microbial spores, fungi. It is stable, after treatment of the skin (hands, surgical field) it remains on it in a certain amount sufficient to exhibit a bactericidal effect. Retains activity (albeit somewhat reduced) in the presence of blood, pus, various secretions and organic substances.
It extremely rarely causes allergic reactions, irritation of skin and tissues, and does not have a damaging effect on objects made of glass, plastic and metals.
Pharmacokinetics
Practically not absorbed from the gastrointestinal tract. After accidental ingestion of 300 mg, Cmax is reached after 30 minutes and is 0.206 μg/l.
It is excreted mainly in feces (90%), less than 1% is excreted by the kidneys.
Indications
As a preventive and therapeutic agent for various infections, for antiseptic treatment and disinfection.
0.05%, 0.1%, 0.2% aqueous solutions:
- Postoperative care for patients in ENT and dentistry departments.
0.05% and 0.2% solutions:
- Purulent wounds, infected burns, bacterial and fungal diseases of the skin and mucous membranes in dentistry (rinsing and irrigation - gingivitis, stomatitis, aphthae, periodontitis, alveolitis);
- Prevention of infections in surgery, urology, obstetrics and gynecology;
- Prevention of sexually transmitted infections (chlamydia, ureaplasmosis, trichomoniasis, gonorrhea, syphilis, genital herpes - use no later than 2 hours after sexual intercourse);
- · Disinfection of skin (abrasions, cracks).
0.2% solution:
- Treatment and sanitation of the genital tract in gynecology during therapeutic and diagnostic procedures;
- Disinfection of removable dentures.
0.5% solution:
- Treatment of wounds and burn surfaces; treatment of infected abrasions and cracks of the skin, open mucous membranes.
- Sterilization of medical instruments at a temperature of 70°C.
1% solution:
- Disinfection of thermometers, working surfaces of medical equipment and devices, the heat treatment of which is undesirable;
- Treatment of the surgical field and the surgeon's hands before surgery, disinfection of the skin, treatment of postoperative and burn wounds.
5% concentrate:
- Preparation of aqueous, glycerin and alcohol solutions with concentrations from 0.01 to 1%.
Contraindications
Hypersensitivity to the components of the drug, dermatitis.
Carefully:
Children's age (up to 18 years)
Directions for use and doses
Chlorhexidine is used as a prophylactic and therapeutic agent externally and locally, as well as for disinfection.
0.05%, 0.02% and 0.5% aqueous solutions are used in the form of irrigation, rinsing and applications (5-10 ml are applied to the affected surface of the skin or mucous membranes):
- To treat the surgical field, dilute a 20% solution with 70% ethyl with an exposure of 1-3 minutes, 2-3 times a day (on a tampon or by irrigation).
- Alcohol in a ratio of 1:40. The resulting 0.5% aqueous-alcohol solution of chlorhexidine is treated with the surgical field 2 times with an interval of 2 minutes.
- For postoperative care of patients in the ENT and dentistry departments, a solution (0.05% and 0.1%) for rinsing is usually prescribed 2-3 times a day.
- Complex treatment of urethritis and urethroprostatitis is carried out by injecting 2-3 ml of a 0.05% solution of chlorhexidine bigluconate into the urethra 1-2 times a day, the course of treatment is 10 days, procedures are prescribed every other day.
- To wash the bladder during cystoscopy, use a 0.02% sterile aqueous solution.
- For the prevention of sexually transmitted diseases, chlorhexidine bigluconate is effective if it is used no later than 2 hours after sexual intercourse. A diluted 0.05% solution is injected into the urethra for men (2-3 ml), women (1-2 ml) and into the vagina (5-10 ml) for 2-3 minutes. It is also necessary to treat the skin of the inner thighs, pubis, and genitals. After the procedure, do not urinate for 2 hours.
For disinfection:
Treatment of medical instruments and working surfaces is carried out with a clean sponge moistened with an antiseptic solution, or by soaking. To quickly sterilize instruments, use the same 0.5% solution for 5 minutes.
A 0.1% aqueous solution of chlorhexidine can be used to disinfect premises, sanitary equipment, etc.
| Procedure | Dilution of the drug and type of solvent | Concentration of solution containing chlorhexidine bigluconate | Special Requirements |
| Disinfection of hands and surgical field | 1:40 in 70% ethyl alcohol | 0,5 % | Treatment with the solution for at least 5 minutes. |
| Antiseptic treatment of wounds and burns | 1:40 in the water | 0,5 % | Use sterilized water. Sterilize the solution at a temperature of 115-116 °C for 30 minutes in an autoclave. |
| Antiseptics in gynecology and obstetrics | 1:400 | 0,05 % | Use sterilized water. The solution is sterilized at a temperature of 115-116 °C for 30 minutes in an autoclave. |
| Cystoscopy, bladder lavage | 1:1000 in water or saline sodium chloride solution. | 0,02 % | Sterile solution. |
| Washing of the peritoneum, pleura (operational procedures) | 1:1000 in water | 0,02 % | Sterile solution |
| Antiseptics for urethral catheterization | 1:400 | 0,05 % | Combine aseptically with sterile glycerin. |
Side effects
In rare cases - allergic reactions (skin rash), dry skin, itching, dermatitis, stickiness of the skin of the hands (within 3-5 minutes), photosensitivity. Changes in tooth color, tartar deposits and taste disturbances with long-term use for oral antiseptics.
Overdose
In case of accidental ingestion, it is practically not absorbed (gastric lavage should be done using milk, raw egg, gelatin or mild soap). If necessary, symptomatic therapy is carried out.
Interaction
Used in a neutral environment; at pH 5-8 the difference in activity is small; at pH more than 8, a precipitate forms. The use of hard water somewhat reduces the bactericidal properties.
Chlorhexidine bigluconate is a cationic substance and does not combine with soap and other anionic compounds such as colloids, gum arabic, carboxymethylcellulose.
At a concentration of 1:2000, it is incompatible with borates, carbonates, chlorides, citrates, phosphates, sulfates, creating poorly soluble sediments after 24 hours.
Compatible with drugs containing a cationic group (benzalkonium chloride, cetrimonium bromide).
Increases the sensitivity of bacteria to chloramphenicol, kanamycin, neomycin, cephalosporins.
Ethanol enhances the effectiveness of the drug.
special instructions
Avoid getting the drug inside the wound in patients with open traumatic brain injury, spinal cord injuries, or perforation of the eardrum.
In case of contact with the mucous membranes of the eyes, they should be quickly and thoroughly rinsed with water.
Do not mix chlorhexidine with other disinfectants and detergents. Contact with hypochlorine bleaches on fabrics that have previously been in contact with chlorhexidine-containing products may cause brown stains. Do not expose clothing that has been in contact with chlorhexidine to hypochlorites and other compounds that release active chlorine.
Do not dilute with hard water. Aqueous solutions can be sterilized in an autoclave at 116 °C for 30 minutes. Do not sterilize using ionizing radiation.
Release form
Concentrate for the preparation of solutions for local and external use 20%, 500 ml in colored polypropylene bottles with a cap.
For pharmacies - 1 bottle with instructions in a cardboard box.
For hospitals - 16 bottles per box with instructions.
Storage conditions
At temperatures from 1 °C to 25 °C. Protect from light.
Keep out of the reach of children.
Best before date
Diluted solutions should be stored for no more than a week.
Do not use after expiration date.
Conditions for dispensing from pharmacies
Over the counter.
Chlorhexidine bigluconate - instructions for medical use - RU No. P N015600/01 dated 2004-04-16
Synonyms of nosological groups
| Category ICD-10 | Synonyms of diseases according to ICD-10 |
|---|---|
| N30 Cystitis | Exacerbation of chronic cystitis |
| Acute bacterial cystitis | |
| Recurrent cystitis | |
| Urethrocystitis | |
| Fibrous cystitis | |
| Cystopyelitis | |
| T14.1 Open wound of unspecified body area | Secondary healing processes |
| Limp granulating wounds | |
| Slow healing wounds | |
| Slow-healing wounds | |
| Deep wounds | |
| Purulent wound | |
| Granulating wounds | |
| Long-term non-healing wound | |
| Long-term non-healing wound and ulcer | |
| Long-term non-healing soft tissue wound | |
| Wound healing | |
| Wound healing | |
| Capillary bleeding from superficial wounds | |
| Bleeding wound | |
| Radiation wounds | |
| Slowly epithelializing wounds | |
| Minor cuts | |
| Festering wounds | |
| Impaired wound healing processes | |
| Violation of skin integrity | |
| Violations of the integrity of the skin | |
| Violations of the integrity of the skin | |
| Small cuts | |
| Uninfected wounds | |
| Uncomplicated wounds | |
| Surgical wound | |
| Primary treatment of superficial contaminated wounds | |
| Primary treatment of wounds | |
| Primary delayed treatment of wounds | |
| Poorly scarring wound | |
| Poor wound healing | |
| Poorly healing wound | |
| Superficial wound | |
| Superficial wound with slight exudation | |
| Wound | |
| Large wound | |
| Bite wound | |
| Wound process | |
| Wounds | |
| Slow-healing wounds | |
| Stump wounds | |
| Gunshot wounds | |
| Wounds with deep cavities | |
| Difficult-to-heal wounds | |
| Hard-to-heal wounds | |
| Chronic wounds |
From this article you will learn:
- Chlorhexidine - use as a mouth and throat rinse,
- pros and cons of the drug, analogues,
- how much does chlorhexidine cost - price in a pharmacy in 2019.
The article was written by a dentist with more than 19 years of experience.
Chlorhexidine or chlorhexidine digluconate (full name) is a broad-spectrum antiseptic that is effective against most pathogenic oral bacteria. Therefore, the drug is widely used both in dentistry and ENT practice - usually in the form of a 0.5% solution. Available without a prescription.
The drug has no age restrictions - with one “but”. In children under 3 years of age, for use in the oral cavity, it can only be used in the form of a spray, or using gauze swabs moistened with an antiseptic solution. At the same time, up to 3 years of age, it is forbidden to spray the tonsils and throat (so that the drug does not enter the respiratory tract) - when treating tonsillitis and pharyngitis.
Chlorhexidine: photos of packaging from different manufacturers
How to rinse your mouth with chlorhexidine -
Chlorhexidine solution for rinsing the mouth and throat is most often used in a 0.05% concentration. The solution is already ready for use, i.e. There is no need to dilute it with water! The standard regimen for mouth rinsing is 2 times a day (after meals and brushing teeth in the morning and evening), for 10 days.
A number of manufacturers produce mouthwash solutions with a chlorhexidine concentration of 0.1-0.2%, and they are certainly stronger. In addition, there are combination preparations in which chlorhexidine is combined either with a second antiseptic (for example, cetylpyridine) or with extracts of medicinal plants. There are also forms of release of chlorhexidine in the form of gels for gums (see examples below).
Chlorhexidine: application in dentistry and ENT
Chlorhexidine solution has one unique property, which makes it the most effective antiseptic for the oral cavity. When rinsing, a thin film of chlorhexidine bigluconate is formed on the surface of the oral mucosa, which continues to act after rinsing for several more hours (on average about 5-7 hours).
Thus, the wide spectrum of action on most pathogenic bacteria and the high residual concentration of this antiseptic make it possible to effectively use it for the following dental and ENT diseases -
Chlorhexidine: price, composition and release forms
Prices are for 2019. You can buy chlorhexidine for only 20-30 rubles - for a 100 ml bottle with a concentration of 0.05%. Chlorhexidine spray, which is produced by the manufacturer YuzhPharm, is somewhat more expensive, and in this case the bottle will be equipped with a spray dispenser (Fig. 4).
In defense, it is worth noting that blackening occurs only on those surfaces of the teeth on which there is a layer of bacterial plaque or tartar (Fig. 5-6). There are also advantages to this - you will immediately notice that it is time for you to go to the dentist for a dental procedure. In addition, the darkening of the teeth will be temporary and will disappear within a few days after the end of the rinsing course.
Chlorhexidine mouth rinse - detailed analysis of indications for use
We have already said that chlorhexidine has very high effectiveness due to its high antimicrobial activity and high residual concentration on the mucous membrane after rinsing. Chlorhexidine instructions for use for the oral cavity include the following main indications for use of the drug...
- After tooth extraction
–
usually after removal, antiseptic rinses are prescribed 2-3 times a day (rinse for 1 minute). Moreover, you need to rinse your mouth not with active movements, but simply put an antiseptic in your mouth and “cheat a little”, because active rinsing movements will almost certainly lead to the loss of a blood clot from the socket of the extracted tooth, and the development of inflammation in the latter.After tooth extraction, you should rinse your mouth with chlorhexidine especially in the following cases: 1) if the removal was difficult, 2) if the tooth was removed due to inflammation, 3) if you have carious teeth or dental deposits in your mouth, infection in which can lead to suppuration blood clot in the socket.
- With alveolitis of the socket of an extracted tooth
–
chlorhexidine for mouth rinsing for alveolitis (this is the name for inflammation of the socket of an extracted tooth) is an excellent remedy for its treatment. Normally, the socket after removal is closed by a blood clot (Fig. 8), but if the clot falls out or its necrotic disintegration as a result of inflammation, the socket may look like in Fig. 9.
- After opening the flux
–
If you have an opening on your gum (in common parlance - gumboil) and a drainage has been placed in the incision, then antiseptic rinses are extremely necessary. This is due to the fact that pus will be released from the incision, spreading throughout the entire oral cavity. Antiseptics will help protect the oral mucosa and tonsils from purulent infection. Important: you don’t need to rinse too vigorously, because... otherwise the drain may fall out of the incision.
- For inflammation/bleeding gums
–
The main symptoms of gum inflammation are redness, swelling and bleeding. The causes of inflammation are exclusively soft microbial plaque and hard dental deposits (Fig. 12-13). For inflammation of the gums, Chlorhexidine digluconate can and should be used, and more effective treatment results can be achieved by combining such antiseptic rinses with anti-inflammatory applications
- For stomatitis(Fig. 14) –
as we said above: chlorhexidine for stomatitis caused by the herpes virus is completely ineffective, because its antiviral activity practically approaches zero. But for aphthous stomatitis, rinsing with chlorhexidine is used, but again not as the main treatment, but only as part of complex therapy. For the herpetic form of stomatitis, another antiseptic is used that has antiviral activity, called (Fig. 15).
Well, it’s very important -
- Duration of the course of antiseptic rinses –
A course of mouth rinsing with 0.05% chlorhexidine should not exceed 10-12 days, otherwise you will be guaranteed oral dysbacteriosis. The use of solutions of 0.1-0.2% concentration is no longer than 8-10 days. Long-term use can lead to suppression of even good microflora and, over time, lead to a decrease in the local immunity of the oral mucosa, which will make the mucosa less resistant to the development of stomatitis and fungal infections.If you would like to continue the course of antiseptic rinses, then after the end of the 10-day period of using Chlorhexidine, it is better to switch to ones containing fluorides and extracts of medicinal plants. Such rinses will not harm you even with prolonged use.
- Remember that for gum inflammation, Chlorhexidine is effective only as part of complex therapy, and only after removing dental plaque. Don’t make the mistakes of many thousands of people who suppress the symptoms of inflammation with antiseptics and antibiotics, while the inflammation progresses unnoticed. When such people already go to the dentist, there is nothing that can be done to help them except to refer them for removal of loose teeth.
Chlorhexidine during pregnancy, in children -
Chlorhexidine can be used without restrictions during pregnancy and breastfeeding, but preferably in courses of no more than 10 days. The drug is not absorbed into the blood and has only surface activity. Studies have not revealed a negative effect of the drug in these groups of patients. Chlorhexidine in children can also be used in short courses of up to 10 days (there is no age limit).
Important: children under 3 years old do not know how to rinse their mouths and therefore may choke. Therefore, their oral cavity can be treated either with gauze swabs soaked in an antiseptic solution, or using Chlorhexidine spray. However, keep in mind that in children under 3 years of age, the spray can be used to irrigate the mucous membrane of the entire oral cavity, with one exception - you cannot spray the spray into the throat or tonsils. The latter can only be done in children after 3 years of age.
Storage conditions -
- store in a place protected from light at a temperature not exceeding 25°C.
- shelf life: 2 years,
- store in places inaccessible to children,
- do not use after expiration date.
We hope that our article on the topic: Chlorhexidine bigluconate instructions for use was useful to you!
Sources:
1. Add. professional,
2. Personal experience as a dental surgeon, periodontist,
3. National Library of Medicine (USA),
4.
American Academy of Periodontology (USA),
5. Ingredients of the products are taken from the official websites of the manufacturers.
Manufacturer: YuzhPharm LLC Russia
ATS code: D08AC02
Farm group:
Release form: Liquid dosage forms. Solution for external use.
General characteristics. Compound:
Active ingredient: 0.05% chlorhexidine bigluconate.
Excipient: purified water.
Pharmacological properties:
Pharmacodynamics. The product is bactericidal against gram-positive and gram-negative bacteria (including pathogens), tuberculocidal, virucidal (acute respiratory viral infections, herpes, hepatitis of all types, including hepatitis A, B and C, adenovirus, etc.) and fungicidal (in action against fungi of the genera Candida and Trichophyton).
According to the parameters of acute toxicity, “Chlorhexidine bigluconate 0.05% - YuzhPharm” belongs to class 4 of low-hazardous substances according to GOST 12.1.007-76 when applied to the skin, introduced into the stomach and inhaled. According to the classification of Sidorov K.K. when administered parenterally, the drug belongs to class 5 of practically non-toxic compounds. Skin-resorptive and sensitizing properties in the recommended modes of use of the product have not been identified.
The product has a moderate irritant effect on the mucous membranes of the eyes. The maximum permissible concentration in the air of the working area of chlorhexidine bigluconate is 1 mg/m3.
The product can be used to treat the skin of children from birth.
Indications for use:
The product "Chlorhexidine bigluconate 0.05% - YuzhPharm" is intended for use in medical institutions:
For hygienic treatment of the hands of medical personnel, including personnel of ambulances;
- for disinfecting the skin of the injection field;
- for sanitary treatment of the skin and the skin of the feet to prevent fungal diseases;
- for disinfection of rubber gloves worn by personnel (made of materials resistant to chemicals) during surgical interventions and manipulations requiring surgical antiseptics, when working with potentially infected material (microbiological and other laboratories); when collecting medical waste of classes B and C.
- for disinfection of small instruments of simple configuration;
- as a prophylactic agent in the form of irrigation, rinsing and application on the surface of the skin, mucous membranes;
- for hygienic treatment of the hands of students of educational institutions, staff of preschool and school institutions, social security institutions (nursing homes, hospices, etc.), employees of perfumery and cosmetics enterprises (including hairdressers, beauty salons, etc.), public catering, municipal facilities, food and chemical-pharmaceutical industries;
- for hygienic treatment of the skin of the hands, injection field, sanitary treatment of the skin and skin of the feet for the purpose of preventing fungal diseases, as a prophylactic for the population in everyday life.
Important! Get to know the treatment
Directions for use and dosage:
Hygienic treatment of hands: 3 ml of the product is applied to the hands and rubbed into the skin until dry for 30 seconds.
Treatment of the injection field, incl. at the site of vaccination: the skin is wiped with a sterile cotton swab or irrigated until completely moisturized, followed by holding for 30 seconds.
Preventive treatment of the feet, sanitary treatment of the skin: with a copiously moistened cotton swab, carefully treat each foot or area of skin with different cotton swabs or irrigate with the product until the skin is completely moistened, holding time for at least 30 seconds.
Processing of gloves worn by personnel: the outer surface of the gloves is thoroughly wiped with a sterile swab, generously moistened with the product. Processing time - at least 1 minute. Exposure - until the surface of the gloves is completely dry.
Small instruments of a simple configuration: (in healthcare facilities, beauty salons, hairdressers, manicure and pedicure rooms, etc.) must be completely immersed in the product immediately after its use. The thickness of the layer of product above the products must be at least 1 cm. After the disinfection period of 5 minutes is completed, the products are removed from the container and washed with running drinking water for at least 1 minute.
As a prophylactic agent in the form of irrigation, rinsing and application - 5-10 ml of solution is applied to the surface of the skin or mucous membranes with an exposure of 1-3 minutes 2-3 times a day (on a tampon or by irrigation).
Features of application:
Use for external use only. Do not use the product after the expiration date. If the product accidentally gets into the stomach, it is recommended to drink several glasses of water with the addition of an adsorbent (for example, 10-15 crushed tablets of activated carbon per glass of water). Do not induce vomiting! If necessary, seek medical help.
Contraindications:
Skin-resorptive and sensitizing properties in the recommended modes of use of the product have not been identified. The product has a moderate irritant effect on the mucous membranes of the eyes.
Storage conditions:
Store in tightly closed manufacturer's packaging at temperatures from 0 ºС to +30 °С; away from sources of heat and fire; Avoid storage in direct sunlight. No smoking! Store separately from medications, out of the reach of children. Transportation by any means of transport is allowed in accordance with the rules for the carriage of goods in force for this type of transport, at temperatures from 0 ° C to +30 ° C. The product's shelf life is 2 years in unopened manufacturer's packaging.
Vacation conditions:
Over the counter
Package:
The product is packaged in 25 ml, 50 ml, 100 ml in orange glass bottles. 25 ml, 50 ml, 100 ml, 200 ml, 500 ml, 1000 ml in high-pressure polyethylene bottles with a polymer nozzle, or with a special nozzle with a screw cap, or equipped with a spray pump and a protective polyethylene cap. 5 l each; 10 l; 20 liters in low-density polyethylene canisters (for hospital use).
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