What You Need to Know about CHG, Hospital Care, and Infection Control
Chlorhexidine, commonly referred to as CHG, could be putting many patients at risk in hospital and clinical settings. To understand why, let’s first talk about what this chemical is.
CHG is a disinfectant and antiseptic that is used for skin disinfection before surgery and to sterilize surgical instruments. It may be used both to disinfect the skin of the patient and the hands of the healthcare providers. It is also used for cleaning wounds, preventing dental plaque, treating yeast infections of the mouth, and to keep urinary catheters from blocking.
This product sounds powerful, however in February of this year (2017), the FDA (U.S. Food and Drug Administration) issued a warning regarding the use of CHG. This medical treatment has been in use since the 1950’s, yet in recent years alternative solutions are actively being sought to replace this. With more and more conditions and infections resisting drugs and antibiotics, using chemicals such as chlorhexidine could trigger resistance in harmful bugs or kill of beneficial bacteria, causing dangerous consequences. The greater use of CHG could warrant surveillance for resistance to superbugs.
FDA warnings should not be taken lightly, as decisions and recommendations are based on discovery – changing years of historical recommendation is a big deal. In May 2017 the CDC (Centers for Disease Control and Prevention) issued a new surgical guideline regarding the use of CHG for pre-surgical bathing, “Do not apply antimicrobial agents (ie, ointments, solutions, or powders) to the surgical incision for the prevention of SSI – surgical site infections. surgical Thus, indirectly recommending not using CHG.
These FDA and CDC warnings come on the heels of spikes in incident reports, such as rashes, burns, skin irritations, and life-threatening conditions directly linked to the use of CHG. Studies have also found chlorhexidine may cause chemical burns in children under the age of 2 months.
CHG has been known to be used in the treatment of MRSA, a bacteria responsible for several difficult-to-treat infections in humans. MRSA is not only a major risk factor, it is also a concern for athletes. MRSA infections have been on the rise in hospital patients since 2013.
The rise of drug resistant infection in clinical settings should be a concern. How do we protect the skin, the body’s largest organ? With various drug companies lobbying to stay on top, the questions arises, will health or money be priority in patient care?
The FDA has required the maker of CHG to include a warning label warning consumers against using it as a “general skin cleaner.” This speaks volumes both in hospitals, locker rooms, and home care.
The more we understand the microbiome of the skin, perhaps the more answer we will have in how to properly care for it. Is our skin or health at risk over long-standing big business or will we find common ground in procedure care and shift dollars in discovering new solutions?
- Source Reuters – Industry Backing Muddies Infection Control Science – April 7, 2017
- Source – JAMA Surgery Special Communication – Centers for Disease Control and Prevention Guidelines for the Prevention of Surgical Site Infection, 2017 – May 3, 2017 –