Drug points: Intranasal chlorhexidine resulting in anaphylactic circulatory arrest

About 6% of sites treated with a chlorhexidine chip experience a minor adverse event

“…In addition, some adverse events associated with CHX have been reported in the literature. [1][2][3][4] This literature is not referenced, and no information is provided whether the investigators were actively looking for minor symptoms of any such known adverse events.…”

Generalized urticaria after skin cleansing and urethral instillation with chlorhexidine‐containing products

“…Chlorhexidine is an antiseptic which has been widely used for the last 30 years for skin and mucous membranes. There have been several published reports of anaphylactoid and delayed‐type reactions ( Table 1 [ 1–7]). In all nine cases of anaphylactic shock reported to the Japanese Ministry of Welfare between 1967 and 1984, chlorhexidine gluconate had been used on mucous membranes (vagina and urinary bladder) [ 4].…”

“…In 1985, the Japanese manufacturer advised against the use of chlorhexidine gluconate on mucous membranes, and recommended that chlorhexidine gluconate be used on wound surfaces at the lowest bactericidal concentration of 0.05%. In the UK during 1965–1996, the Committee on Safety of Medicines received 182 reported reactions to products containing chlorhexidine [ 7]. Most of these were cutaneous or mucosal eruptions, but to date there have been two reports of anaphylactic shock [ 7].…”

Chlorhexidine

“…41 Of greater concern are the multiplying case reports of chlorhexidine-induced anaphylaxis. 72 When an operative procedure is brief, anaphylaxis from these sources of chlorhexidine exposure may transpire in the recovery room rather than the surgical theater. Anaphylaxis has been described after chlorhexidine application to unbroken skin 55 and minor wounds, 51,52,54 whole body bathing, 56 ophthalmic wash, 57 and gel for urethral catheterization 58,59 or digital rectal examination.…”