Editing Chlorhexidine (section)

== Uses ==
Chlorhexidine is used in disinfectants (disinfection of the skin and hands), cosmetics (additive to creams, toothpaste, deodorants, and antiperspirants), and pharmaceutical products (preservative in eye drops, active substance in wound dressings and antiseptic mouthwashes).<ref name="guanidine">{{citation | vauthors = Güthner T, Mertschenk B, Schulz B | contribution=Guanidine and Derivatives | title=Ullman's Encyclopedia of Industrial Chemistry | edition=7th | publisher=Wiley | year=2007 | page=13 }}</ref>

In [[endodontics]], chlorhexidine has been used for root canal irrigation and as an intracanal dressing.<ref>{{cite journal | vauthors = Raab D | title = Preparation of contaminated root canal systems – the importance of antimicrobial irrigants. | journal = Dental Inc. | date = July–August 2008 | pages = 34–36 }}</ref><ref>{{cite journal | vauthors = Raab D | title = Die Bedeutung chemischer Spülungen in der Endodontie | journal = Endodontie Journal | date = 2010 | issue = 2 | pages = 22–23 | url = http://www.oemus.com/archiv/pub/sim/ej/2010/ej0210/ej0210_22_23_raab.pdf }}{{Dead link|date=April 2023 |bot=InternetArchiveBot |fix-attempted=yes }}</ref>

=== Antiseptic ===
Chlorhexidine is active against [[Gram-positive bacteria|Gram-positive]] and [[Gram-negative bacteria|Gram-negative]] organisms, [[facultative anaerobes]], [[aerobes]], and yeasts.<ref name="tox" /> It is particularly effective against Gram-positive bacteria (in concentrations ≥ 1&nbsp;μg/L). Significantly higher concentrations (10 to more than 73 μg/mL) are required for Gram-negative bacteria and fungi. Chlorhexidine is ineffective against [[polioviruses]] and [[adenoviruses]]. The effectiveness against herpes viruses has not yet been established unequivocally.<ref name="disinfectants">{{cite encyclopedia | vauthors= Harke HP | chapter = Disinfectants | encyclopedia=Ullman's Encyclopedia of Industrial Chemistry | edition=7th | publisher=Wiley | year=2007 | pages=10–11 }}</ref>

There is strong evidence that chlorhexidine is more effective than [[povidone-iodine]] for clean [[surgery]].<ref>{{cite journal | vauthors = Wade RG, Burr NE, McCauley G, Bourke G, Efthimiou O | title = The Comparative Efficacy of Chlorhexidine Gluconate and Povidone-iodine Antiseptics for the Prevention of Infection in Clean Surgery: A Systematic Review and Network Meta-analysis | journal = Annals of Surgery | volume = 274 | issue = 6 | pages = e481–e488 | date = December 2021 | pmid = 32773627 | doi = 10.1097/SLA.0000000000004076 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Dumville JC, McFarlane E, Edwards P, Lipp A, Holmes A, Liu Z | title = Preoperative skin antiseptics for preventing surgical wound infections after clean surgery | journal = The Cochrane Database of Systematic Reviews | volume = 2015 | issue = 4 | pages = CD003949 | date = April 2015 | pmid = 25897764 | pmc = 6485388 | doi = 10.1002/14651858.CD003949.pub4 }}</ref> Evidence shows that it is an effective antiseptic for upper limb surgery.<ref name=":1" />

Meta-data spanning several decades shows that the efficacy of chlorhexidine (against organisms that cause surgical site infection) has not changed,<ref>{{cite journal | vauthors = Aftab R, Dodhia VH, Jeanes C, Wade RG | title = Bacterial sensitivity to chlorhexidine and povidone-iodine antiseptics over time: a systematic review and meta-analysis of human-derived data | journal = Scientific Reports | volume = 13 | issue = 1 | pages = 347 | date = January 2023 | pmid = 36611032 | pmc = 9825506 | doi = 10.1038/s41598-022-26658-1 | bibcode = 2023NatSR..13..347A }}</ref> dispelling concerns over emerging resistance.

=== Dental use ===
[[File:Perichlor, 0.12% chlorhexidine glucomate solution medication.jpg|thumb|Perichlor brand 0.12% chlorhexidine gluconate solution]]

Use of a chlorhexidine-based mouthwash in combination with normal tooth care can help reduce the build-up of plaque and improve mild [[gingivitis]].<ref name="coch2017">{{cite journal | vauthors = James P, Worthington HV, Parnell C, Harding M, Lamont T, Cheung A, Whelton H, Riley P | title = Chlorhexidine mouthrinse as an adjunctive treatment for gingival health | journal = The Cochrane Database of Systematic Reviews | volume = 3 | issue = 3 | pages = CD008676 | date = March 2017 | pmid = 28362061 | pmc = 6464488 | doi = 10.1002/14651858.CD008676.pub2 | doi-access = free }}</ref> There is not enough evidence to determine the effect in moderate to severe gingivitis.<ref name="coch2017" /> Its use as a mouthwash has a number of [[adverse effect]]s including damage to the mouth lining, tooth discoloration, [[Calculus (dental)|tartar]] build-up, and impaired taste.<ref name=coch2017/> Extrinsic tooth staining occurs when chlorhexidine rinse has been used for four weeks or longer.<ref name="coch2017" />

Mouthwashes containing chlorhexidine which stain teeth less than the classic solution have been developed, many of which contain [[chelation|chelated]] [[zinc]].<ref name="pmid16451475">{{cite journal | vauthors = Bernardi F, Pincelli MR, Carloni S, Gatto MR, Montebugnoli L | title = Chlorhexidine with an Anti Discoloration System. A comparative study | journal = International Journal of Dental Hygiene | volume = 2 | issue = 3 | pages = 122–126 | date = August 2004 | pmid = 16451475 | doi = 10.1111/j.1601-5037.2004.00083.x }}</ref><ref>{{cite journal | vauthors = Sanz M, Vallcorba N, Fabregues S, Müller I, Herkströter F | title = The effect of a dentifrice containing chlorhexidine and zinc on plaque, gingivitis, calculus and tooth staining | journal = Journal of Clinical Periodontology | volume = 21 | issue = 6 | pages = 431–437 | date = July 1994 | pmid = 8089246 | doi = 10.1111/j.1600-051X.1994.tb00741.x }}</ref><ref>{{cite journal | vauthors = Kumar S, Patel S, Tadakamadla J, Tibdewal H, Duraiswamy P, Kulkarni S | title = Effectiveness of a mouthrinse containing active ingredients in addition to chlorhexidine and triclosan compared with chlorhexidine and triclosan rinses on plaque, gingivitis, supragingival calculus and extrinsic staining | journal = International Journal of Dental Hygiene | volume = 11 | issue = 1 | pages = 35–40 | date = February 2013 | pmid = 22672130 | doi = 10.1111/j.1601-5037.2012.00560.x }}</ref>

Chlorhexidine is a [[cation]] which interacts with [[anionic]] components of [[toothpaste]], such as [[sodium lauryl sulfate]] and [[sodium monofluorophosphate]], and forms salts of low solubility and reduced antibacterial activity. Hence, to enhance the antiplaque effect of chlorhexidine, "it seems best that the interval between toothbrushing and rinsing with CHX [chlorhexidine] be more than 30 minutes, cautiously close to two hours after brushing".<ref>{{cite journal | vauthors = Kolahi J, Soolari A | title = Rinsing with chlorhexidine gluconate solution after brushing and flossing teeth: a systematic review of effectiveness | journal = Quintessence International | volume = 37 | issue = 8 | pages = 605–612 | date = September 2006 | pmid = 16922019 }}</ref>

=== Topical ===<!-- This section is redirected to from [[Septol]]. -->
Chlorhexidine gluconate is used as a skin cleanser for surgical scrubs, as a cleanser for skin wounds, for preoperative skin preparation, and for germicidal hand rinses.<ref name="tox" /> Chlorhexidine [[eye drop]]s have been used as a treatment for eyes affected by [[Acanthamoeba keratitis|''Acanthamoeba'' keratitis]].<ref name="Alkharashi">{{cite journal | vauthors = Alkharashi M, Lindsley K, Law HA, Sikder S | title = Medical interventions for acanthamoeba keratitis | journal = The Cochrane Database of Systematic Reviews | volume = 2015 | issue = 2 | pages = CD010792 | date = February 2015 | pmid = 25710134 | pmc = 4730543 | doi = 10.1002/14651858.CD010792.pub2 }}</ref>

Chlorhexidine is a very effective antiseptic and its use is growing in the world for treating the umbilical cord. A 2015 [[Cochrane review]] has yielded high-quality evidence that within the community setting, chlorhexidine skin or cord care can reduce the incidence of [[omphalitis]] (inflammation of the [[umbilical cord]]) by 50% and neonatal mortality by 12%.<ref>{{cite journal | vauthors = Sinha A, Sazawal S, Pradhan A, Ramji S, Opiyo N | title = Chlorhexidine skin or cord care for prevention of mortality and infections in neonates | journal = The Cochrane Database of Systematic Reviews | volume = 2015 | issue = 3 | pages = CD007835 | date = March 2015 | pmid = 25739381 | doi = 10.1002/14651858.CD007835.pub2 | s2cid = 16586836 | pmc = 10638659 }}</ref>