Chlorhexidine has bactericidal antimicrobial activity, especially against gram-positive microorganisms. The first compound to enter the market was chlorhexidine gluconate, registered in 1954 by Imperial Chemical Industries Co.LTD (UK) as "Gibitan" - the world's first recognized antiseptic for treating wounds and skin. In 1957, only 3 years after entering the market, the indications for its use were expanded, including not only skin treatment, but also use in ophthalmology, urology, gynecology and otorhinolaryngology. And now chlorhexidine is relevant and widely used in medicine as an antiseptic and disinfectant for the skin, as well as surfaces and instruments.
Chlorhexidine is an amphipathic molecule with hydrophilic and hydrophobic groups; it is a cation at physiological pH.
Typically, chlorhexidine is used in the form of salts, mainly biacetate, digluconate or dihydrochloride salt. Bigluconate is most soluble in water and alcohols. In addition, this form has the added advantage of being released at physiological pH. Chlorhexidine has a number of unique properties and benefits:
1. Chlorhexidine acts at the level of the cell membrane, increasing its permeability. Rapidly adsorbed on the cell wall of the microorganism, chlorhexidine destroys it, thereby preventing the reproduction of the microorganism and suppressing growth and development. The mechanism of action of chlorhexidine is very similar to that of quaternary ammonium compounds (QAC), which have a proven antiseptic effect against gram-positive, gram-negative pathogens.
2. Substantiveness (independence), that is, it works effectively without outside help, namely, when it binds to various substrates, it retains its antimicrobial activity.
3. Toxicity to humans and mammals is quite low, especially in comparison with alcohols (used in dentistry).