tions and prevent the spread of organisms like
Methicillin-resis-tant Staphylococcus aureus (MRSA). Chlorhexidine is effective
against both transient (viruses) and resident (bacteria) organisms
on the skin but is not as effective against spores.
Chlorhexidine is characterized as being a strong base with cationic properties. The compound is said to have hydrophilic (
di-guanido) and hydrophobic (hexane) groupings, which react with
different parts of the microbe. These parts are essential to the
electrostatic balance required for the four categories of microstructure germs that the medicinal chemist is concerned with:
1) Gram positive or 2) negative bacteria and 3) enveloped or 4)
naked viruses. The significance of the nitrogenous groups is the
positive charge that allows the compound to adhere to either the
negative surface of bacteria and viruses or to the surface of human skin. It is here that chlorhexidine fulfills one of its most important medical roles as a pre-surgical dressing. There is evidence
that when chlorhexidine is combined with alcohol its germicidal
effect is potentiated against both bacteria and viruses.
Chlorhexidine was patented by Imperial Chemical Industries
in Manchester, England (1954) for usage as a bactericide to be
used on tissues and instruments. It is constantly compared with
povidone-iodine as to their important roles in preventing surgical
site infections (SSIs) with a slight edge often given to chlorhexidine. The development of chlorhexidine was based on knowledge
gained over the years from analysis of the range and speed of
action of the quaternary compounds.
Povidone-iodine, an antiseptic solution based on a novel form
of molecular iodine, is a WHO-recommended agent for dressing wounds and for pre-surgical antisepsis. Since 18214 the effective use of iodine as an antiseptic has generally led us to believe
that there may be no more powerful killer of bacteria/fungi or
inactivator of the viral agent than this halogen. Today the medical
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FIGURE 2: Structural formula of Chlorhexidine.