0.25% chlorhexidine gluconate gel. A protective topical microbicide.
OBJECTIVE
An estimated 4 million new cases of chlamydial infection occur each year. This experiment assessed the effects of a vaginally applied gel formulation of 0.25% chlorhexidine gluconate on chlamydial infection and on the vaginal ecosystem.


METHODS
Twelve monkeys were treated with a single application of 0.25% chlorhexidine gluconate. These animals were assessed for changes in vaginal flora before and at 30 minutes, 1 day, and 2 days postapplication by microbiologic analysis. Cervical and vaginal tissues were assessed by colposcopy at each time point. Five monkeys received a single application of 0.25% chlorhexidine gluconate gel followed (30 minutes) by a cervical inoculation with Chlamydia trachomatis. Four monkeys were inoculated with Chlamydia only. Cervicovaginal tissues were assessed via modified colposcopy, vaginal swabs were collected for assessment of vaginal flora, and cervical swabs were collected for detection of Chlamydia (culture/ligase chain reaction) at baseline and days 1, 2, and 7 postinoculation.


RESULTS
Changes in vaginal flora were minimal in all monkeys. Application of 0.25% chlorhexidine gluconate did not affect adversely vaginal colonization by lactobacilli. All chlamydial infection control monkeys were infected, whereas none of the five monkeys pretreated with chlorhexidine gluconate were positive for C. trachomatis by culture or ligase chain reaction. Colposcopic observations remained largely unchanged in all groups.


CONCLUSIONS
A 0.25% chlorhexidine gluconate gel was protective against chlamydial infection in all animals tested, had no adverse effect on the vaginal flora, and had minimal effect on cervicovaginal tissues after a single application.
Department of Obstetrics and Gynecology, University of Washington, Seattle 98195-6460, USA.
D L
DL
Patton
Y T
YT
Sweeney
T L
TL
McKay
S M
SM
DeMers
A M
AM
Clark
L K
LK
Rabe
S L
SL
Hillier
D000282:Administration, Intravaginal; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002690:Chlamydia Infections / Q000517:prevention & control*; D002692:Chlamydia trachomatis; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005782:Gels; D008254:Macaca nemestrina; D014621:Vagina / Q000382:microbiology
D000900:Anti-Bacterial Agents; D005782:Gels; C010882:chlorhexidine gluconate; D002710:Chlorhexidine