Chlorhexidine - A Broad-Spectrum Antiseptic in Clinical and Dental Use
Karpiński, T. M., et al. Eur Rev Med Pharmacol Sci 19.7 (2015): 1321-1326.
Chlorhexidine (CHX) is a widely used antiseptic known for its broad-spectrum antimicrobial properties. At low concentrations, it is bacteriostatic; at higher levels, it becomes bactericidal by disrupting microbial cell membranes.
Medical Applications
CHX is effective in reducing surgical site infections (SSIs) when used for preoperative skin preparation. Hospital studies also show that CHX bathing reduces hospital-acquired infections more effectively than soap and water. In obstetrics, topical CHX on the umbilical cord lowers neonatal mortality and helps prevent post-cesarean infections.
Dental Applications
Dentistry is the primary field for CHX use, with formulations including mouthwashes (0.12-0.2%), gels, sprays, and varnishes (up to 40%). Key uses include:
· Plaque & Gingivitis Control: Reduces plaque and inflammation.
· Alveolar Osteitis Prevention: Pre- and post-op rinsing lowers dry socket risk.
· Caries Prevention: Inhibits Streptococcus mutans growth.
· Halitosis Treatment: Reduces anaerobic bacteria linked to bad breath.
· Endodontics: Used in root canal irrigation for antimicrobial action.
Limitations
Prolonged use may cause tooth and restoration staining, taste disturbances, and mucosal irritation. CHX effectiveness can also be reduced in organic-rich environments and is pH-dependent.
Boosting the Effectiveness of Chlorhexidine Endodontic Irrigant Using CPC (Cetylpyridinium Chloride) Surfactant Formulation
Al-Obaidy, Saba SM, et al. Pharmaceutics 13.9 (2021): 1389.
Chlorhexidine (CHX) is widely used as an endodontic irrigant, although it can encounter efficacy problems against resistant microbes. In this study, we evaluated the effect of the addition of 0.2% cetylpyridinium chloride (CPC) cationic surfactant to 2% CHX as an enhancer of the antimicrobial properties of CHX.
Methodology: The test product, a 2% CHX+0.2% CPC combination irrigant formulation, was assessed for in vitro antimicrobial activity and compared to a negative control (2% CHX alone) and 100% MTAD (positive control; a commercial irrigant with known antibacterial efficacy). The samples were tested against E. faecalis, S. aureus, and C. albicans bacteria and fungi.
Key Results:
· Against E. faecalis: All irrigants-CHX, CHX+CPC, and MTAD-showed similar levels of antimicrobial activity. The CPC addition did not significantly alter CHX efficacy.
· Against S. aureus: 2% CHX was significantly more effective than MTAD. The CHX+CPC combination showed equivalent efficacy to CHX alone, suggesting CPC does not diminish CHX's antibacterial action.
· Against C. albicans: Both CHX and CHX+CPC were markedly more effective than MTAD. Notably, CPC improved the formulation's antifungal potency without compromising its stability or performance.