Synergism between Chlorhexidine and Sulphadiazine

Abstract

Chlorhexidine and sulphadiazine react synergistically against strains of Pseudomonas. Proteus and Staphylococcus, with high factors of synergy. The impermeability of these strains to sulphadiazine is destroyed by low concentrations of chlorhexidine, permitting the accumulation of sulphadiazine which then inhibits protein synthesis. The combination of these drugs is bactericidal.

Role of antibiotic prophylaxis for the prevention of intravascular catheter-related infection

“…Silver sulfadiazine exhibits potent bactericidal and fungicidal activity [90,91] and it has been used topically for preventing burn wound infection. In addition, the combination of chlorhexidine and silver sulfadiazine has a synergistic effect against a range of micro‐organisms [92]. On the other hand, in vitro studies [93] and studies in animals [94] have demonstrated that the combination of minocycline and rifampin is effective in preventing the colonization of catheters with slime‐producing staphylococci, and that it also displays a broad‐spectrum inhibitory activity against Gram‐negative bacteria and yeast cells.…”

Biofilm-based Healthcare-associated Infections

“…This catheter became available ~12 years ago, is polyurethane-based and impregnated with minute amounts of chlorhexidine and silver sulfadiazine (ArrowGard, Arrow International, Reading, PA, USA). A synergistic effect of chlorhexidine and sulfadiazine has been shown in vitro (Quesnel et al 1978 ). This fi rstgeneration CHSS catheter is coated only on the exterior surface and exhibits antimicrobial properties for ~15 days.…”

“…A catheter with reduced microbial adhesion, and to be used for various medical applications Cook Spectrum™ catheter (Cook Critical Care, Bloomington, IN, USA) and is coated on the inner and outer surface with minocycline and rifampicin Broad-spectrum activity against gram-negative and -positive organisms and C. Albicans Raad et al ( 1995Raad et al ( , 1996aRaad et al ( , b , c , 1997a, Johnson et al ( 1999 ) Chlorhexidine and silver sulfadiazine (CHSS) catheter A signifi cant reduction in catheter colonisation Quesnel et al ( 1978 ), Brun-Buisson et al ( 2004 ) PET (polyethyleneterephtalate, Dacron™) and ePTFE (expanded polytetrafl uorethylene) vascular prostheses soaked in an antibiotic solution or in cyclodextrins Reduction in microbial adherence on the vascular grafts Richardson et al ( 1970 ), Galdbart et al ( 1996 ), Blanchemain et al ( 2007 ) Erlanger' silver and Oligon' catheters (silver-coated catheters)…”

A Note on the Anti‐Pseudomonas Activity of Cephalosporins with Chlorhexidine

“…The disc tests failed to display the interactions of chlorhexidine with /?-lactam antibiotics. Other drugs showed significant interactions with chlorhexidine, some of which have already been studied (sulphonamide, Quesnel et al 1978;chioramphenicol, Quesnel, pers. comm.).…”