Chlorhexidine (Burns / Wound Antiseptic)

How it works

Its cationic biguanide structure binds negatively charged bacterial cell membranes, disrupting them and causing leakage of cell contents, giving broad activity against Gram-positive and Gram-negative organisms.

Prescribing in practice

• Chlorhexidine can cause anaphylaxis, and the MHRA has warned of this risk with medical and antiseptic products, so a history of reaction must be sought and exposure avoided in sensitised patients.
• It is for external use only and should be kept away from the eyes, middle ear, and meninges as it is neurotoxic and ototoxic to those tissues.
• Contact dermatitis and local irritation can occur with repeated application to broken skin.

Monitoring

Monitor for hypersensitivity reactions and for local skin irritation with repeated use.

Counselling the patient

• This wash or solution helps reduce germs on the skin and wounds.
• Tell staff immediately about any rash, swelling, or breathing difficulty, and keep it away from the eyes.

Evidence & guidelines

Chlorhexidine is a standard antiseptic for skin and wound antisepsis; the MHRA has issued safety advice on the risk of anaphylactic reactions.