title: Evaluation with a focus on both the antimicrobial efficacy and cumulative skin irritation potential of chlorhexidine gluconate alcohol-containing preoperative skin preparations.
abstract: BACKGROUND
  Important characteristics for ideal skin preparations include long-lasting antimicrobial efficacy and low potential for skin irritation.
  
  
  METHODS
  A total of 55 healthy adult subjects were enrolled to evaluate the antimicrobial effects of 3 test formulations applied to inguinal, abdominal, and antecubital sites at post-treatment time points of 30 seconds, 72 hours, and 7 days. To investigate skin irritation potential, the 3 formulations were tested in a 21-day repeat-insult patch test conducted on the skin of the backs of 23 healthy subjects.
  
  
  RESULTS
  The mean log(10) reduction (MLR) at 7 days post-treatment produced by a 79% vol/vol ethanol containing 1% wt/vol chlorhexidine gluconate (1% CHG-EtOH) applied to abdominal sites was significantly superior to that produced by a 10% povidone-iodine solution (2.45 MLR vs 0.90 MLR; P < .05). The 1% CHG-EtOH and a 70% vol/vol isopropanol containing 2% wt/vol CHG (2% CHG-IPA) provided statistically equivalent persistence at 72 hours and 7 days post-treatment. The 1% CHG-EtOH had less skin irritation potential than the 2% CHG-IPA and the 10% povidone-iodine solution, although the differences were not statistically significant (P > .05).
  
  
  CONCLUSIONS
  Considering its persistent effect and low skin irritation potential, the 1% CHG-EtOH preparation is expected to perform well in surgical site preparation to reduce the risk of surgery- and catheter-related bloodstream infection.
authors.affiliation: Research and Development Division, Yoshida Pharmaceutical Co. Ltd., Tokyo, Japan. nishihara_yutaka@yoshida-pharm.co.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nishihara
authors.forename: Takumi
authors.initials: T
authors.lastname: Kajiura
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Yokota
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Okubo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000438:Alcohols / Q000008:administration & dosage* / Q000009:adverse effects; D002710:Chlorhexidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D004202:Disinfectants / Q000008:administration & dosage* / Q000009:adverse effects; D004203:Disinfection / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D012867:Skin / Q000187:drug effects / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000438:Alcohols; D004202:Disinfectants; C010882:chlorhexidine gluconate; D002710:Chlorhexidine