Compendium of the most significant studies with reference to properties, intake, effects.

Fangaia SIG, Nicolau PMG, Guerra FADRA, Rodrigo MM, Utzeri G, Cabral AMTDPV, Valente AJM, Esteso MA, Ribeiro ACF. Effect of Cobalt and Chromium Ions on the Chlorhexidine Digluconate as Seen by Intermolecular Diffusion. Int J Mol Sci. 2021 Dec 9;22(24):13266. doi: 10.3390/ijms222413266. 

Abstract. The effect of the chlorhexidine digluconate, which is commonly used in mouthwash formulations, on the transport of these salts is evaluated in this paper by using the Taylor dispersion technique, which will allow an assessment of how the presence of chlorhexidine digluconate (either in aqueous solution or in a commercial formulation) may affect the diffusion of metal ions. 

Kapralos V, Rukke HV, Ørstavik D, Koutroulis A, Camilleri J, Sunde PT. Antimicrobial and physicochemical characterization of endodontic sealers after exposure to chlorhexidine digluconate. Dent Mater. 2021 Feb;37(2):249-263. doi: 10.1016/j.dental.2020.11.011.

Abstract. Assess the antibacterial, physical and chemical properties of AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS) in contact with 2% chlorhexidine digluconate (CHX) used as final irrigant prior to root canal obturation.

Alvendal C, Mohanty S, Bohm-Starke N, Brauner A. Anti-biofilm activity of chlorhexidine digluconate against Candida albicans vaginal isolates. PLoS One. 2020 Sep 17;15(9):e0238428. doi: 10.1371/journal.pone.0238428.

Abstract. Candida albicans is the main pathogen associated with both sporadic and recurrent candidiasis. Due to unsatisfactory treatment effect, the impact of chlorhexidine digluconate and fluconazole alone or in combination on C. albicans and biofilm was investigated.

Vallejo RBB, Fernandez DS, Cervera LA, Aragón LM, Iglesias MEL, Yurrita LRC, Lopez DL. Effectiveness of surgical hand antisepsis using chlorhexidine digluconate and parachlorometaxylenol hand scrub: Cross-over trial. Medicine (Baltimore). 2018 Oct;97(42):e12831. doi: 10.1097/MD.0000000000012831. 

Abstract. We conducted a randomized, double-blind, controlled crossover trial to compare the bacterial loads on fingertips and fingernails under laboratory conditions after use of antiseptic test products, including chlorhexidine digluconate 4%, PCMX 3%, and a reference solution of propan-1-ol 60% (P-1). 

Marty Cooney R, Manickam N, Becherer P, Harmon LS, Gregg L, Farkas Z, Shea LM, Parekh P, Murphy J, Shade W. The use of 3.15% chlorhexidine gluconate/70% alcohol hub disinfection to prevent central line-associated bloodstream infections in dialysis patients. Br J Nurs. 2020 Jan 23;29(2):S24-S26. doi: 10.12968/bjon.2020.29.2.S24. 

Abstract. This study found that using alcohol with chlorhexidine gluconate prior to accessing central line hubs and vascular grafts allows for reduction in CLABSI events and sustains statistically significant lower CLABSI rates in the inpatient dialysis population.

Jusino-Leon GN, Matheson L, Forsythe L. Chlorhexidine Gluconate Baths: Supporting Daily Use to Reduce Central Line-Associated Bloodstream Infections Affecting Immunocompromised Patients. Clin J Oncol Nurs. 2019 Apr 1;23(2):E32-E38. doi: 10.1188/19.CJON.E32-E38.

Abstract. The project focused on supporting staff and nurses by providing education and training on current practices to staff and patients, and identifying barriers. Direct observation and chart audits were the approach chosen to implement the project.

Yoo MS, Jin HJ, Lee SY. Synergistic Antibacterial Efficacies of Chlorhexidine Digluconate or Protamine Sulfate Combined with Laminaria japonica or Rosmarinus officinalis Extracts against Streptococcus mutans. Biocontrol Sci. 2020;25(1):41-44. doi: 10.4265/bio.25.41.

Abstract.  The purpose of this study was to investigate the synergistic effect of chlorhexidine digluconate and protamine sulfate on the inhibitory activity of L. japonica and R. officinalis extracts against Streptococcus mutans, a major etiological agent for dental caries. 

Rudolf JL, Moser C, Sculean A, Eick S. In-vitro antibiofilm activity of chlorhexidine digluconate on polylactide-based and collagen-based membranes. BMC Oral Health. 2019 Dec 26;19(1):291. doi: 10.1186/s12903-019-0979-y.

Abstract. The purpose of this in-vitro-study was to elucidate, if rinsing with a chlorhexidine digluconate solution (CHX) prevents bacterial adhesion, and whether it interferes with attachment of periodontal ligament (PDL) fibroblasts and epithelial cells to membrane surfaces.

Cucina A, Filali S, Risler A, Febvay C, Salmon D, Pivot C, Pelandakis M, Pirot F. Dual 0.02% chlorhexidine digluconate - 0.1% disodium EDTA loaded thermosensitive ocular gel for Acanthamoeba keratitis treatment. Int J Pharm. 2019 Feb 10;556:330-337. doi: 10.1016/j.ijpharm.2018.12.016.

Abstract. The aim of this work was to formulate an original anti-amoebic thermoreversible ocular gel combining biguanide and metalloproteases inhibitor - chelating agent.

Chlorhexidine digluconate is a chemical compound, a cationic biguanide compound, gluconate salt of chlorhexidine.

It appears as a transparent liquid.

What it is used for and where

Take only under medical supervision

Chemical intermediate. Broad spectrum microbicide against pyogenic bacteria, hospital infection pathogens, airborne pathogens, intestinal pathogens, pathogenic yeasts and fungi.

Medical

Widely used as a sterilisation antiseptic against both gram-positive and gram-negative bacteria. It has been found to have anti-biofilm activity (1), in vivo bactericidal efficacy during surgical hand scrub preparations (2), increased residual antiseptic activity on the skin after application (3), increased residual antiseptic activity on the skin after application. Effective in 0.02% ophthalmic solutions (4).

Like all drugs it can cause side effects. Always ask the physician.

Chlorhexidine digluconate studies

Appearance	Transparent clear liquid
Boiling Point	699.3ºC at 760 mmHg
Melting Point	134ºC
Flash Point	376.7ºC
Density	1.06 g/mL at 25 °C
pH	5.5-7.0
Residue on ignition	≤0.1%
Water Solubility	50% (w/v)
Assay	19.0-21.0%
Safety

• Molecular Formula  C₃₄H₅₄Cl₂N₁₀O₁₄
• Molecular Weight     897.8
• CAS  18472-51-0
• UNII    MOR84MUD8E
• EC Number   242-354-0
• DSSTox Substance ID  DTXSID5034519
• IUPAC  (1E)-2-[6-[[amino-[(E)-[amino-(4-chloroanilino)methylidene]amino]methylidene]amino]hexyl]-1-[amino-(4-chloroanilino)methylidene]guanidine;(2R,3S,4R,5R)-2,3,4,5,6-pentahydroxyhexanoic acid
• InChI=1S/C22H30Cl2N10.2C6H12O7/c23-15-5-9-17(10-6-15)31-21(27)33-19(25)29-13-3-1-2-4-14-30-20(26)34-22(28)32-18-11-7-16(24)8-12-18;2*7-1-2(8)3(9)4(10)5(11)6(12)13/h5-12H,1-4,13-14H2,(H5,25,27,29,31,33)(H5,26,28,30,32,34);2*2-5,7-11H,1H2,(H,12,13)/t;2*2-,3-,4+,5-/m.11/s1  
• InChl Key      YZIYKJHYYHPJIB-UUPCJSQJSA-N
• SMILES C1=CC(=CC=C1NC(=NC(=NCCCCCCN=C(N)N=C(N)NC2=CC=C(C=C2)Cl)N)N)Cl.C(C(C(C(C(C(=O)O)O)O)O)O)O.C(C(C(C(C(C(=O)O)O)O)O)O)O
• MDL number  MFCD00083599
• PubChem Substance ID    329775206
• ChEBI  28312
• RXCUI  20791    
• NACRES NA.83  
• NCI   C47974

Synonyms:

• 1,6-Bis(N⁵-[p-chlorophenyl]-N¹-biguanido)hexane; 
• 1,1′-Hexamethylenebis(5-[p-chlorophenyl]biguanide)

References_______________________________________________________________________

(1) Jeyakumar J, Sculean A, Eick S. Anti-biofilm Activity of Oral Health-care Products Containing Chlorhexidine Digluconate and Citrox. Oral Health Prev Dent. 2020 Oct 27;18(1):981-990. doi: 10.3290/j.ohpd.a45437.

(2) Labadie JC, Kampf G, Lejeune B, Exner M, Cottron O, Girard R, Orlick M, Goetz ML, Darbord JC, Kramer A. Recommendations for surgical hand disinfection -- requirements, implementation and need for research. A proposal by representatives of the SFHH, DGHM and DGKH for a European discussion. J Hosp Infect. 2002 Aug;51(4):312-5. doi: 10.1053/jhin.2002.1243. 

(3) Maiwald M, Chan ES. The forgotten role of alcohol: a systematic review and meta-analysis of the clinical efficacy and perceived role of chlorhexidine in skin antisepsis. PLoS One. 2012;7(9):e44277. doi: 10.1371/journal.pone.0044277.

(4) Lin SC, Huang CF, Shen LJ, Wang HJ, Lin CY, Wu FL. Formulation and stability of an extemporaneous 0.02% chlorhexidine digluconate ophthalmic solution. J Formos Med Assoc. 2015 Dec;114(12):1162-9. doi: 10.1016/j.jfma.2014.08.003.