Monday, 14 March 2016

PS60 Guidelines on the perioperative management of patients with suspected or proven hypersensitivity to chlorhexidine. ANZCA 2015.

Chlorhexidine is a broad spectrum antiseptic that is extensively used in healthcare environments. It is observed that incidence of anaphylaxis has been increasing in recent years. There is no centralized database in Australia for reporting chlorhexidine allergery. However in Royal North Shore Hospital Anaesthetic Allergy Clinic alone, there are 29 cases of confirmed chlorhexidine anaphylaxis between 2007 to 2015. This is the third most common allergen after neuromuscular blockers and antibiotics

Issues include:
  • Difficulty in identifying products containing chlorhexidine
    • Chlorhexidine is increasingly incorporated in antiseptic handrub solutions, gels, pastes, dressings and devices (including central venous catheters and drape).
    • There is inconsistent labeling of products that contain chlorhexidine
  • Difficulty avoiding contact with chlorhexidine products once identified
Suggested perioperative management of patients with chlorhexidine allergy include:
  • development of a chlorhexidine product register throughout each hospital
  • development of a “chlorhexidine free box” in operating theatres – containing chlorhexidine free laternative for common procedures such as skin antisepsis, lubrication jelly for IDC insertion, chlorhexidine free central venous access device

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