MDA/2012/075
Allergic reactions to Chlorhexidine products
You will be aware that the MHRA has released a Medical Device Alert for devices and medicinal products that contain Chlorhexidine and the Directorate has to inform the Trust as to how we are going to respond to this alert.
The Dental Directorate uses products containing Chlorhexidine on a daily basis: mouth rinses, spray, gel, and PerioChip. Over 30 years, I cannot recollect any case of a patient demonstrating hypersensitivity or allergy to Chlorhexidine products used in the Hospital so clearly the type of incident mentioned in the MHRA report is extremely rare, but nevertheless most serious and potentially life-threatening.
Our response should be sensible, appropriate yet proportionate to the problem.
It is therefore important that:
- We continue to ensure that any history of allergic or hypersensitive reactions are explored as part of the medical history for all patients;
- We ask specifically, all patients to whom
- (i)we recommend chlorhexidine as ‘over-the-counter’ products (predominantly mouth rinses and gel) or
- (ii)we are applying chlorhexidine products professionally (pocket irrigants, PerioChip, oral gels or sprays or a combination as part of full mouth disinfections)
whether they have a known allergy to the product. The response to this question must be recorded clearly in the patient’s case records contemporaneously and before any application is made.
We also have to identify any ‘follow-up’ action to show that we are complying with the response to the Alert and we will most likely limit this to an audit of case notes on the Periodontology Department for those patients who have been treated with a chlorhexidine product.