The Compatibility of a Variety of Skin Care Formulations Dressings with Chlorhexidine Digluconate

Many claims of efficacy and safety of skin care products are made, but very little is known about their compatibility with other formulations commonly used in patient care. One important example is chlorhexidine digluconate (CHG) containing formulations.  CHG is an antimicrobial agent commonly found in surgical scrubs, surgical preps, cleansing wipes and cleansing bath solutions. It is documented that certain compounds, such as cellulose gums, carbomer, anionic surfactants and soaps¹  have the potential to deactivate CHG. Since it is not possible to determine the effect on the CHG in a given formulation simply by reading the ingredients on the label, 3 compatibility studies^2-4 were undertaken.  The purpose of the following studies was to evaluate 13 different formulations some of which containing compounds (at low levels) which have the potential (as stated in the literature) to deactivate CHG. In these studies a given skin care formulation was exposed to CHG formulations in a manner representative of clinical use. The following pathogens were evaluated in triplicate: Staphylococcus aureus - MRSA, Escherichia coli, Serratia marcescens, Pseudomonas aeruginosa, Candida albicans and Staphylococcus epidermidis, and Serratia marcescens relative to controls. It was concluded that the 13 skin care formulations were compatible with the CHG formulations as the bactericidal activity of CHG was not compromised. Based upon these studies ‘CHG incompatibility’ may be dose dependent. It is hoped that studies of this type will allow for enhanced clinician education, patient safety and prove beneficial to facilities with respect to managing infection.