ChloraPrep FAQs

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Q.

What are the active ingredients of ChloraPrep?

A.

The active ingredients in ChloraPrep are chlorhexidine gluconate (CHG) 2% v/v and isopropyl alcohol (IPA) 70% v/v.

Q.

What is the coverage area of each applicator?

A.

The coverage area is specific to each applicator.

  • Sepp: 5cm x 8cm
  • Frepp: 10cm x 13cm
  • 3ml: 15cm x 15cm
  • 10.5ml: 25cm x 30cm
  • 26ml: 50cm x 50cm

Q.

What is the shelf life of ChloraPrep products?

A.

All ChloraPrep products are labeled with a two-year shelf-life from the date of production.

Q.

How long does it take to prep a patient using ChloraPrep?

A.

Prepping time varies by the location and size of the prep site and applicator used. Gently apply with a back and forth motion, concentrating at the insertion/incision site/s for 30 seconds before working outwards to the periphery. Always let the solution air dry fully before continuing with the procedure.

Q.

Why do the directions on the ChloraPrep SmPC indicate that it should be applied in a back-and-forth direction?

A.

Clinical testing has shown that the back-and-forth motion used to apply ChloraPrep supports the efficacy of the solution. Because 80% of transient skin flora resides in the first five cell layers of skin7, it is important to reach those lower cell layers and kill the bacteria dwelling further down. The skin contains many cracks and crevices where harmful bacteria reside. The back-and-forth action creates friction and helps work the solution into crevices and lower layers. Further, there is no published data to support the concentric circle application methodology.

The Marketing Authorisation (MAA) approved by the MHRA for ChloraPrep included in vivo studies which showed that a minimum 3 log10 reduction for 48 hours was achieved on moist sites, and a 2 log10 reduction for 24 hours was achieved on dry sites while using a friction (back-and-forth) cleaning motion.

Q.

How do I know which applicator to use for a certain procedure?

A.

Each ChloraPrep applicator is appropriate for a variety of procedures, depending on the size of the area that needs to be prepped. To review a list of common applicator procedures, go to the Product Line Page.

Q.

Has ChloraPrep been approved for use in small children?

A.

ChloraPrep is approved for patient preoperative skin preparation for children over 2 months of age.

Q.

Is ChloraPrep safe to use with all procedures?

A.

Please read the SmPC for details of warnings and precautions.

Q.

Why is the combination of 2% chlorhexidine gluconate (CHG) and 70% isopropyl alcohol (IPA) better than IPA alone?

A.

The combination of fast-acting and long-lasting antimicrobial activity is the key to an effective skin antiseptic. IPA alone provides a 99.99% reduction in bacteria, but it does not provide long-lasting microbial kill. CHG maintains antimicrobial activity, demonstrating 2 log10 and 3 log10 for at least 48 hours1, 3 compared to two hours for free iodine.4 Because ChloraPrep contains the combination of isopropyl alcohol and chlorhexidine, it is superior to isopropyl alcohol alone.

Q.

How is ChloraPrep superior to traditional iodophors?

A.

Advantages of ChloraPrep include its broad spectrum, rapid-acting, and persistent antimicrobial activity (48 hours) and effectiveness in the presence of blood and organic matter. These advantages are a result of the unique 2% CHG/70% IPA formulation of ChloraPrep. Chlorhexidine gluconate, a cationic bisbiguanide, works by destroying the bacterial cell membrane and precipitating cell contents. Alcohol denatures cell proteins. As a result ChloraPrep provides better broad spectrum, immediate, cumulative, and residual antibacterial activity compared to traditional iodophors.1, 2, 4

In contrast, traditional iodophors can take two to three minutes until the free release of iodine can occur. While the iodophor dries, free iodine becomes available. The iodine then attacks the bacterial cell and the oxidation of two sulfhydryl groups, resulting in the formation of a disulfide bond. The effectiveness of iodophors is = three hours. Lastly, iodophors are neutralized in the presence of blood and organic matter and have greater irritation than the CHG solution.1, 4

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Please note, not all products, services or features of products and services may be available in your local area. Please check with your local BD representative.

References
  1. Analyses comparing the antimicrobial activity and safety of current antiseptic agents: A review, Hibbard JS, J Infus Nurs 2005; 28: 194-207
  2. Current approaches for the prevention of surgical site infections, Florman S, Nichols RL, Am J Infect Dis 2007; 3: 51-61
  3. Comparison of ChloraPrep™ and Betadine® as preoperative skin preparation antiseptics, Garcia R, Hibbard JS, Mulberry G et al, Abstracts of the Infectious Disease Society of America 40th Annual Meeting 2002: Abs 418
  4. Skin antisepsis: past, present, and future, Crosby CT, Mares AK, J Vasc Access Devices 2001; Spring: 26-31
  5. Data on file, BD
  6. Microbial Ecology of Human Skin in Health and Disease, Fredericks DN, J Invest Dermatol Symp Proc 2001; 6: 167-9
  7. Effect of topical antimicrobial treatment on aerobic bacteria in the stratum corneum of human skin, Hendley JO, Ashe KM, Antimicrob Agents Chemother 1991; 35: 627-31
  8. Chlorhexidine: Expanding the armamentarium for infection control and prevention, Milstone AM, Passaretti CL, Perl TM, CID 2008; 46: 274-80
  9. Evaluation of donor arm disinfection techniques, McDonald CP, Lowe P, Roy A, Vox Sanguinis 2001; 80: 135-41
  10. The management and control of hospital acquired infection in acute NHS trusts in England, National Audit Office, February 2000
  11. The socioeconomic burden of hospital acquired infection, Plowman R, Graves N, Griffin M et al, www.dh.gov.uk
  12. The cost-effectiveness of 2% chlorhexidine gluconate in 70% isopropyl alcohol in prevention of central venous access device-related infections in patients admitted to ITU, York N, Hartley-Jones c, Hutchinson J et al, Poster presented at 37th Annual Infection Control Conference, UK, September
  13. Reducing blood-culture contamination rates by the use of a 2% chlorhexidine solution applicator in acute admission units, Madeo M, Barlow G, Hosp Infect 2008; 69: 307-9
  14. Efficacy of surgical preparation solutions in foot and ankle surgery, Ostrander RV, Botte MJ, Brage ME, J Bone Joint Surg Am 2005; 87: 980-5
  15. Prospective, randomised clinical trial to compare the efficacy of two 70% (v/v) isopropyl alcohol (IPA) solutions containing either 0.5% (w/v) or 2% (w/v) chlorhexidine gluconate (CHG) for skin antisepsis during coronary artery bypass grafting (CABG), Casey AL, Itrakjy AS, Harbun C et al, Poster presented at European Congress of Clinical Microbiology and Infection Diseases (ECCMID), Spain, April 2008

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