2023-12-04 15:14:07
1,1-hexamethylene bis [5 -(4chlorophenyl)biguanide digluconate]better known as chlorhexidine, is a broad spectrum antiseptichaving antibacterial, antiviral and antifungal activity, used since the 1950s.
Due to its presence for two decades in many products, the risk of sensitization to this molecule is not negligible. These include: solutions for skin use, mouthwashes, lozenges, eye drops, urological gels, certain hygiene products (toothpastes, for example) and certain cosmetics (sometimes used as a preservative)… Exposure to this substance therefore concerns a large number of people.
Contact via the skin, vein or mucous membranes can then cause immediate IgE-mediated allergic manifestations, ranging from urticaria and/or angioedema to anaphylaxis within minutes of contact. The first case of anaphylaxis with chlorhexidine was observed in 1984. Since then, this antiseptic has been ranked fourth among causes. the most frequent intraoperative accidents, following curares, antibiotics and latex. The prevalence of these severe allergic reactions is estimated in Great Britain at between 7.7 and 9% of intraoperative accidents, 9.6% in Denmark, 9% in Belgium. In France, it is significantly lower: 1.2%. Between 2011 and 2012, the GERAP (study group of peranesthetic anaphylactic reactions) had listed 50 intraoperative anaphylactic reactions, including 15 linked to the use of chlorhexidine; note that in France povidone-iodine is preferred for preoperative antisepsis.
The circumstances triggering anaphylaxis are often linked to the preparation of the skin with this antiseptic before a surgical procedure or the installation of a venous access, to the installation of a central venous catheter impregnated with chlorhexidine, to lubricating gel for urethral catheterization , use of dressings containing chlorhexidine…
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