Disinfection with 10% povidone-iodine versus 0.5% chlorhexidine gluconate in 70% isopropanol in the neonatal intensive care unit

AIM: The finding that 10% povidone-iodine skin disinfectant may compromise thyroid function in premature infants prompted its replacement with 0.5% chlorhexidine gluconate solution in 70% isopropanol. The objective of this study was to compare the incidence rates of true infection and contamination associated with the use of these two disinfectants in the neonatal intensive care unit. METHODS: The study population comprised two cohorts of infants admitted to our neonatal intensive care unit: 1) in 1992-1993 when only 10% povidone-iodine was used as a skin disinfectant, and 2) in 1995-1996 when only 0.5% chlorhexidine gluconate solution in 70% isopropanol was used. A retrospective chart review was conducted to determine whether all documented positive blood, CSF and suprapubic aspirate cultures indicated true infection or contamination. True infection was defined as clinical symptoms and/or laboratory abnormalities suggestive of sepsis, with positive blood, CSF or suprapubic aspirate cultures. RESULTS: 1146 infants were admitted during the study periods, 507 during the first period and 639 during the second. In the early group, 17.6% of infants had major malformations, 72.0% were premature and 25.2% had weights of < 1500 g. Corresponding percentages for the latter group were 16.0%, 80.6% and 32.9%, respectively. No statistically significant differences were found between the two research periods in rate of infants with positive blood cultures, true infections, or contamination. CONCLUSION: The use of 0.5% chlorhexidine gluconate solution in 70% isopropanol as a skin disinfectant is justified in neonatal intensive care units because it is not associated with an increased incidence of infections as opposed to 10% povidone-iodine and is devoid of detrimental effects.     

Anti-plaque effect of tempered 0.2% chlorhexidine rinse: an in vivo study

OBJECTIVES: The aim of this in vivo study was to compare the anti-plaque effect of warm and cold chlorhexidine gluconate irrigation on matured human plaque. METHODS: In a split-mouth design, the antibacterial effect of 47 degrees C "warm" 0.2% chlorhexidine solution was compared with that of 18 degrees C "cold" rinse at the same concentration on newly-formed supragingival plaque that had been left undisturbed for 72 h. Before and 1 h after a 1-min rinse procedure, plaque was sampled from 10 test persons and vitality determined using vital fluorescence technique. RESULTS: Cold and warm 0.2% chlorhexidine solution reduced plaque vitality significantly from 99.63% to 77.81% (p=0.014) and from 98.98% to 51.77% (p<0.001), respectively. Rinsing with warm chlorhexidine solution reduced plaque vitality to a significantly greater degree (p=0.003) than did cold chlorhexidine. CONCLUSION: In this study, warm 0.2% chlorhexidine rinse showed a significantly more intensive anti-plaque effect than cold chlorhexidine solution at the same concentration.     

Evidence for the early onset of gingival inflammation following short-term plaque accumulation

AIM: A study was undertaken to examine cytokine markers in gingival crevicular fluid (GCF) during the early stages of plaque accumulation. METHODS: A panel of five subjects with good oral hygiene went without brushing for 1 or 3 days, after which GCF samples were taken by placing paper strips into the gingival margins of the maxillary premolars and first molar for 30 s. GCF flow rates were determined with a Periotron instrument (Oraflow, Inc., Plainview, New York), and neutrophils (polymorphonuclear leukocytes) were determined as myeloperoxidase activity. Interleukin-1b (IL-1b) and IL-8 were eluted from the paper strips and assayed with enzyme-linked immunosorbent assay (ELISA) systems. RESULTS: The plaque index rose to 2.7 +/- 0.2 (mean +/- SE) after 3 days without brushing, and the GCF flow rate increased to 146.8% of baseline. PMN and IL-8 concentrations fell but, when corrected for dilution as a result of increased GCF flow, were not statistically different from baseline. IL-1b was slightly elevated after 1 day, and increased to 223.8 +/- 54.3% (from 6.8 +/- 1.7 to 13.8 +/- 3.6 pg/30 s; p = 0.04) after 3 days of plaque accumulation. Resumption of tooth brushing led to a return of IL-1b to baseline (109.1% after 2 days of brushing). When subjects rinsed with 0.12% chlorhexidine during the 3-day no-brushing period, the increases in plaque index, GCF flow rates and IL-1b release rates did not occur. CONCLUSIONS: The results indicate that IL-1b release rates increase in the GCF after 3 days of plaque accumulation, before any clinical signs of inflammation appear.     

贝复新凝胶治疗复发性阿弗他溃疡的临床疗效观察

目的 贝复新凝胶治疗复发性阿弗他溃疡的临床疗效。方法 选取临床就诊的112例复发性阿弗他溃疡患者,随机分成2组,每组各56例,观察组给予复方氯己定含漱+贝复新凝胶局部涂抹,对照组给予复方氯己定含漱+西瓜霜喷剂。比较2组局部治疗效果及平均症状消退和平均治愈时间。结果 观察组经治疗后局部症状消退时间和平均治愈时间明显缩短,无不良反应,局部治疗效果优于对照组（P<0.01）。结论 贝复新凝胶治疗复发性阿弗他溃疡疗效显著安全可靠,值得临床进一步推广和应用。     

Prospective clinical study evaluating the long-time adjunctive use of chlorhexidine after one-stage full-mouth SRP

Abstract: Objectives: Scaling and root planing are the causal procedure in the treatment of periodontitis. Many attempts have been made to improve the outcome. The aim of this study was to verify the influence of the extended use of chlorhexidine after one‐stage full‐mouth (FM) SRP in patients with chronic periodontitis on the clinical outcome after 3 months. Methods: Eighty‐one patients with pockets ≥5 mm were treated by FM. All patients rinsed additionally with 0.2% chlorhexidine (CHX) twice daily over 3 months. Plaque index, bleeding on probing, probing depth (PD) and clinical attachment level (CAL) were recorded at baseline and after 1 and 3 months. Results: In the test group, all variables were significantly improved after 1 and 3 months. Mean reduction of PD and CAL gain was 2.25 ± 1.08 and 1.67 ± 1.08 after 1 and 2.99 ± 1.11 and 2.33 ± 1.31 after 3 months respectively. Conclusions: Over 3 months of extended use of CHX mouth rinse after SRP showed slightly but statistically significant better results.     

Chlorhexidine vaginal wipes prior to elective cesarean section: does it reduce infectious morbidity? A randomized trial

Objective: To evaluate the efficacy of preoperative vaginal cleansing using chlorhexidine 0.25% antiseptic wipes on rates of postcesarean section (CS) infectious morbidities (endometritis, febrile morbidity and wound infection).

Methods: This prospective randomized trial was conducted among 218 pregnant women scheduled for term elective CS. Patients were equally divided into two groups by simple randomization. After spinal anesthesia and catheterization under aseptic technique, the study group had preoperative vaginal cleansing using chlorhexidine 0.25% antiseptic wipes for about 1?min, while the control group did not. All cases received the prophylactic antibiotics and the usual abdominal scrub. All participants received the routine postoperative care without other interventions. Adverse postcesarean infectious morbidities such as endometritis, febrile morbidity and wound infection were observed at the time of hospital discharge and weekly for 6 weeks postpartum.

Results: Both groups were matched regarding the baseline patients’ characteristics (age, gestational age, BMI, operative time and postoperative hospital stay). Overall, post-CS infectious morbidity were significantly reduced from 24.4% in the control group to 8.8% in the intervention group; p value?<0.05. Marked reduction was seen in the incidence of endometritis (13.2% in the control group versus 2.9% in the intervention group; p value?<0.05). However, fever and wound infection showed no significant difference between both groups.

Conclusion: Cleansing the birth canal with chlorhexidine 0.25% wipes prior to elective CS appears to be effective in reducing rates of post-CS infectious morbidity mainly endometritis.     

Chlorhexidine with an Anti Discoloration System. A comparative study

Abstract  Correct oral hygiene is believed to be the basis of primary and secondary prevention. Sometimes, using a toothbrush or other mechanical instruments for oral hygiene may be difficult and it may become necessary to use an antiseptic. Chlorhexidine is an essential component in many available preparations on sale, because of its marked antiseptic qualities. One of the most frequent side-effects is the appearance of stains on the teeth and mucous membranes, which particularly disturbs the patient. A new mouthwash containing chlorhexidine has recently become available, besides maintaining its antiseptic qualities, also avoids the side-effect of staining. Objectives: The aim of this study was to check the capacity of the new mouthwash, which contains chlorhexidine and Anti Discoloration System (ADS), not only to prevent plaque formation like the other mouthwashes containing chlorhexidine but also to avoid staining that is one of the most frequent side-effects. Study design: The comparative study was carried out on a sample of 15 patients treated with two mouthwashes both containing 0.2% chlorhexidine, but different in that the first does not contain ADS, which is instead present in the second, a new product. The results obtained show that in the 15 patients treated, there is no statistically significant difference in the ability of the mouthwash to prevent bacterial plaque, however evidence of the stain was much less with the new mouthwash.     

高效液相色谱法测定多潘立酮片的含量

目的:建立高效液相色谱法测定多潘立酮片的含量。方法:采用SPHERI—5RP—18(220 4.6mm 5um)色谱柱,甲醇—水—三乙胺(60:40:0.5用冰醋酸调节pH值至4.3)为流动相,醋酸氯已定为内标,285nm为检测波长。结果:线性范围为6～60μg·ml~(-1)。在此范围内,浓度与峰面积线性关系良好(γ=0.9996),平均回收率为99.5％,RSD为0.48％(n=6)。结论:本法简便、准确、灵敏。     

复方氯己定含漱液进行口腔护理对重症医学科患者下呼吸道感染的影响观察

目的：探讨重症医学科患者使用复方氯己定含漱液进行口腔护理对下呼吸道感染发生率的影响。方法将2011年10月-2013年9月我院所有入住重症医学科的患者分为复方氯己定含漱液组和对照组,分别采用复方氯己定含漱液（Sempoll牌,含葡萄糖酸氯己定1.2 g/L,甲硝唑0.2 g/L）和生理盐水进行口腔护理,对2组下呼吸道感染的发生率进行比较。结果对照组共592例患者,下呼吸道感染41例,感染率为6.93%;复方氯己定含漱液组共688例患者,下呼吸道感染27例,感染率为3.92%,2组下呼吸道感染发生率比较差异有统计学意义（P〈0.05）。结论对入住重症医学科的患者使用复方氯己定含漱液进行口腔护理,可减少下呼吸道感染的发生。     

高效液相色谱法测定泰唑洗液中甲硝唑和醋酸氯己啶的含量(英文)

目的　建立泰唑洗液中甲硝唑和醋酸氯己啶含量的HPLC测定方法。方法　采用C18柱 (2 5 0mm× 4 .6mm ,10 μm ) ,流动相为甲醇 乙腈 三乙胺缓冲液 (0 .0 5mol·mL-1,用磷酸调节 pH至 2 .5 ) (30∶ 30∶ 4 0 ,v/v ) ,内标物为醋酸泼尼松。流速为 1.0mL·min-1,检测波长为 2 5 4nm。结果　线性范围 :甲硝唑 32～ 12 8μg·mL-1(r =0 .99996 ) ,醋酸氯己啶 2 0～80 μg·mL-1(r =0 .99997)。精密度 :日内及日间RSD为 :甲硝唑 0 .12 % (n =6 )和 0 .32 % (n =5 ) ;醋酸氯己啶 0 .18% (n =6 )和 0 .35 % (n =5 )。平均回收率甲硝唑为 10 0 .4 % (RSD =0 .19%n =5 ) ,醋酸氯己啶为 99.94 % (RSD= 0 .2 0 % ,n =5 )。结论　本法简便 ,快速 ,准确 ,可用于该制剂的质量控制