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Chlorhexidine‐induced anaphylaxis in surgical patients: a review of the literature
Author(s) -
Sharp Gary,
Green Sarah,
Rose Michael
Publication year - 2016
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13269
Subject(s) - medicine , anaphylaxis , chlorhexidine , medline , intensive care medicine , population , intensive care unit , allergy , dermatology , immunology , dentistry , environmental health , political science , law
Background Chlorhexidine ( CHL ) has antiseptic and disinfectant properties used to prevent hospital‐acquired infections. CHL‐induced anaphylaxis is poorly reported in surgical literature despite government warnings and growing recognition. The aim of this review is to increase awareness of CHL ‐induced anaphylaxis in the surgical population. Methods Literature review of E mbase, M edline, P ub M ed and the C ochrane library using ‘anaphylaxis (and) chlorhexidine’ search terms. Results Thirty‐six articles were published on surgical patients suffering anaphylaxis to CHL . Within these, seven patients had two proven separate anaphylactic reactions and one had three separate proven anaphylactic reactions. The most commonly affected speciality was urology. The majority occurred during elective procedures. A history of atopy was surprisingly uncommon as was bronchospasm. Six patients required active chest compressions and 39.71% of patients had their surgical procedure abandoned. Unplanned intensive care admissions occurred in 27.94%. Discussion In order to reduce abandoned procedures, unplanned intensive care unit admissions, morbidity and mortality associated with CHL ‐induced anaphylaxis we recommend the following: rationalization of CHL ‐containing products, greater vigilance regarding subtle symptoms of CHL allergy, appropriate investigation of these symptoms and a greater awareness of CHL ‐containing products. Lastly, we outline the appropriate investigations and highlight the need for meticulous documentation in those who are CHL allergic.