Generic Name

Hibiclens

Mechanism

• Bactericidal/β‑cell lysis: CHG is a bis‑biguanide that binds to bacterial membranes, increasing permeability, leading to leakage of intracellular ions and proteins.
• Broad spectrum: Active against Gram‑positive and Gram‑negative bacteria, many fungi, and some enveloped viruses.
• Residual activity: Sustained low‑level residual effect for up to 12 h, especially when combined with ethanol.

Pharmacokinetics

• Topical only: Minimal systemic absorption when applied to intact skin; <0.5 % of the dose enters circulation.
• Elimination: Rapid dermal clearance; small amounts excreted via kidneys and feces.
• Half‑life: Short systemic half‑life (~0.5 hr) due to low absorption.

Indications

• Pre‑operative skin preparation (surgical, puncture, IV access).
• Hand hygiene for clinicians and patients.
• Debridement or cleansing of contaminated wounds.
• Decontamination of skin before invasive procedures in burn units.

Contraindications

• Known hypersensitivity to chlorhexidine or any excipient.
• Compromised skin (open ulcers, severe dermatitis): avoid prolonged use to prevent cytotoxicity.
• Use in children under 2 yrs: may lead to chlorhexidine poisoning (rare, but avoid).
• Risk of dermatitis: patients with atopic dermatitis or eczema may develop contact dermatitis.

Dosing

• Do not rinse with water unless required for patient safety; residual activity improves efficacy.
• For infants (under 6 months), use 2 % CHG prepared in a dedicated pediatric bottle; avoid high‑concentration solutions.

Adverse Effects

Common
• Mild skin dryness, irritation, stinging.
• Rash or transient eczema.

Serious
• Allergic contact dermatitis.
• Chlorhexidine anaphylactoid reaction (rare, can cause bronchospasm, urticaria).
• Chlorhexidine ingestion (rare, can cause seizures, cardiac arrhythmias).

Monitoring

• Skin integrity: inspect for erythema or maceration after repeated use.
• Allergic reactions: watch for urticaria, bronchospasm after application.
• Eye or mucous membrane exposure: irrigate promptly if contact occurs.

Clinical Pearls

• Residual activity: leaving a thin film of Hibiclens on the skin can reduce microbial counts for hours—ideal for high‑risk procedures.
• Alcohol synergy: Hibiclens contains ethanol; the combination improves rapid killing of spores and provides quicker drying time.
• Product labeling: many pre‑packed “Hibiclens” hand rubs are 4 % CHG; ensure you are not using a 0.5 % or 0.2 % version intended for consumer use.
• Avoid on mucous membranes: not indicated for use on conjunctiva or oral mucosa.
• Inburn victims: use 2 % CHG–based Hibiclens solutions, but always assess for skin fragility; avoid full‑surface application if the skin is necrotic.

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• *This drug card follows current FDA labeling and peer‑reviewed pharmacology references. Use it as a quick reference for clinical practice and student study.*