Absorption and tolerability of aqueous chlorhexidine gluconate used for skin antisepsis prior to catheter insertion in preterm neonates

J Perinatol. 2013 Oct;33(10):768-71. doi: 10.1038/jp.2013.61. Epub 2013 May 23.


Objective: To assess chlorhexidine absorption and skin tolerability in premature infants, following skin antisepsis with 2% aqueous chlorhexidine gluconate (CHG) prior to peripherally inserted central catheter (PICC) placement.

Study design: Neonates less than 32 weeks gestation had skin cleansed with CHG prior to PICC placement. CHG concentrations were measured on serial blood samples. Skin integrity was evaluated for 2 weeks after CHG exposure.

Result: Twenty infants were enrolled; median gestational age was 28 2/7 weeks (range 24 3/7 to 31 4/7). Ten infants had detectable serum chlorhexidine concentrations (range 1.6 to 206 ng ml(-1)). Seven of these infants had their highest serum concentration 2 to 3 days following exposure. No CHG-related skin irritation occurred in any infant.

Conclusion: CHG was detected in the blood of preterm infants receiving CHG skin antisepsis for PICC insertion. Highest serum concentrations occurred 2 to 3 days after exposure. Further investigation is needed to determine the clinical relevance of CHG absorption in preterm infants.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Absorption
  • Anti-Infective Agents, Local / blood
  • Anti-Infective Agents, Local / pharmacokinetics*
  • Antisepsis* / methods
  • Catheterization, Peripheral*
  • Chlorhexidine / analogs & derivatives*
  • Chlorhexidine / blood
  • Chlorhexidine / pharmacokinetics
  • Chromatography, Liquid
  • Female
  • Humans
  • Infant Care
  • Infant, Newborn
  • Infant, Premature*
  • Male
  • Pilot Projects
  • Skin Absorption / drug effects*
  • Tandem Mass Spectrometry


  • Anti-Infective Agents, Local
  • chlorhexidine gluconate
  • Chlorhexidine