Circulation 118,032 • Volume 30, No. 2 • October 2015   Issue PDF

Chlorhexidine Can Cause Allergic Reaction

Claude Abdallah, MD, MSc

Letter to the Editor:

To the Editor:

The use of chlorhexidine is recommended in various clinical settings secondary to its activity against a broad range of organisms. Chlorhexidine is present in different preparations not only as a skin and surgical disinfectant, but also in cosmetics and several pharmaceutical products. Diverse hypersensitivity reactions to chlorhexidine have been described, comprising allergic contact dermatitis, stomatitis, urticaria, dyspnea, and anaphylactic shock. Several cases of chlorhexidine anaphylaxis under anesthesia have been reported with the incidence reported as increasing. Since chlorhexidine is commonly used as skin disinfectant before surgery or invasive procedures, the potential for developing an allergic reaction to chlorhexidine may be significant, especially under anesthesia.

The true incidence of chlorhexidine allergic reactions remains unknown precisely. Anaphylaxis during surgical and interventional procedures may be difficult to evaluate because of the rapid, successive use of multiple drugs. Awareness to this potential problem, including detailed history, testing for chlorhexidine allergy in patients with suspected allergic reaction, and preparedness to treat serious allergic reactions is recommended.

Claude Abdallah, MD, MSc Assistant Professor of Anesthesiology and Pediatrics Children’s National, Washington DC


References:

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  3. Garvey LH, Roed-Petersen J, Husum B. Anaphylactic reactions in anaesthetised patients—four cases of chlorhexidine allergy. Acta Anaesthesiol Scand 2001;45:1290-4. Nakonechna A, Dore P, Dixon T, Khan S, Deacock S, Holding S, Abuzakouk M. Immediate hypersensitivity to chlorhexidine is increasingly recognised in the United Kingdom. Allergol Immunopathol (Madr) 2014;42:44-9.
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  5. Abdallah C. Perioperative chlorhexidine allergy: Is it serious? J Anaesthesiol Clin Pharmacol 2015;31:152-4.