The Determination of Metronidazole and Chlorhexidine Gluconate in Metronidazole and Chlorhexidine Lotion by HPLC

Objective “To establish an HPLC method for the determination of metronidazole and chlorhexidine gluconate in metronidazole and chlorhexidine lotion. Method Using Agilent Eclipse-XDB-C18 chromatographic column, with 0.05 mol·L-1 potassium dihydrogen phosphate solution 1000 ml plus 13.2 ml 10% tetrabutylammonium hydroxide aqueous solution (pH adjusted to 3.5 by phosphoric acid)-acetonitrile (77:23) as Mobile phase, detection wavelength 230 nm. Results The two components could be separated well. The linear ranges of metronidazole and chlorhexidine acetate were 36.33~59.04 μg·ml-1 (r = 0.9994) and 35.45~220.11 μg·ml-1 (r = 1).); The average recoveries were 100.6% and 100.5 %, and the RSD were 0.42% and 0.58%. Conclusion: The method is simple and specific, and the result is more accurate and reliable. Which is suitable for simultaneous determination of two components in compound preparations.

Virucidal Activity of Different Mouthwashes Using a Novel Biochemical Assay

Background: Saliva of patients with COVID-19 has a high SARS-CoV-2 viral load. The risk of spreading the virus is not insignificant, and procedures for reducing viral loads in the oral cavity have been proposed. Little research to date has been performed on the effect of mouthwashes on the SARS-CoV-2 virus, and some of their mechanisms of action remain unknown. Methods: SARS-CoV-2 positive nasopharyngeal swabs measured by RT-PCR were used for virucidal activity in a 1:1 ratio, with an incubation time of 1 min. The solutions used in this study were: iodopovidone (8 mg); * D-limonene, a terpene extracted from citrus peels (0.3%); † cetylpyridinium chloride (0.1%) (CPC); ‡ chlorhexidine gluconate (10%) (CHX); § a CPC (0.12%) and CHX (0.05%) containing formula; ** a formula containing essential oils; †† a CPC containing formula (0.07%); ‡‡ a D-limonene (0.2%) and CPC (0.05%) containing formula; §§ a solution containing sodium fluoride (0.05%) and CPC (0.075%); *** a solution containing CHX (0.12%) and; ††† a CHX (0.2%) containing formula. ‡‡‡ As a control reaction, saline solution or excipient solution (water, glycerin, citric acid, colorant, sodium citrate) was used. Conclusion: Within the limitations of this study, we can conclude that a mouthwash containing both D-limonene and CPC reduced the virucidal activity in about 6 logs (>99.999% reduction). Hence, establishing a clinical protocol for dentists is suggested, where all patients to be treated rinse pre-operatively with a mouthwash containing both D-limonene and CPC to reduce the likelihood of infection with SARS-CoV-2 for dentists. This is a relatively inexpensive way to reduce viral transmission of SARS-CoV-2 from infected individuals within the community. It is also a simple way to decrease infections from asymptomatic and pre-symptomatic patients.

Effect of Temperature on Tooth Staining by 0.12% Chlorhexidine Gluconate

Introduction: Natural color of dentin is affected by many variables, including anatomical variations, age, how much dentin is exposed, or how much enamel is covering the dentin. Chlorhexidine gluconate (CHX) has been observed to cause tooth staining, especially of exposed dentin. Risk factors for CHX staining include the amount of time for CHX utilization amongst others. Interestingly, the temperature of the rinse when used has been identified as a risk factor. However, no evidence of the effect of temperature is available in the literature. The purpose of this study was to determine the effect of temperature on dentin staining due to CHX exposure.Methods: Two studies were done. The first a pilot study at room temperature to determine the time needed to establish staining solutions, a method to evaluate stain intensity, and establish the time needed to stain dentin samples in vitro. The second study exposed dentin samples on a twice daily basis to a 1 min soak in CHX at different temperatures, followed by a period in an unstimulated saliva mixed with black tea mixture. Temperatures tested were 4, 23, 37 and 50°C. Control samples were exposed to only black tea and saliva (no CHX) and tested at 23°C.Results: The pilot study found that the combination of CHX and black tea causes dentin staining. From this data the sample size needed for the second experiment was calculated, requiring 12 samples per group. Sixty dentin samples were divided amongst 5 groups. The data from this study showed significant darkening of the dentin samples over 18 days. The 4 and 23°C CHX rinses resulted in significant staining compared to the control samples. The 37 and 50°C CHX rinses did not stain significantly more than the control samples.Conclusions: Chlorhexidine has the ability to cause tooth staining in the presence of chromogens such as those in black tea. Significant darkening was observed at lower temperatures (4 and 23°C) over 18 days, therefore dental professionals may wish to advise gently warming the CHX rinse toward 37°C prior to use to reduce the risk of staining.

ANTIBACTERIAL EFFECTIVITY OF FLAVONOID FRACTION OF RAMANIA LEAF EXTRACT (Bouea macrophylla Griffith) AGAINST Porphyromonas gingivalis

Background: Chronic periodontitis is a periodontal disease with 80% of all cases of periodontitis. The major causes are the accumulation of plaque and bacteria. The dominant bacteria in chronic periodontitis is Porphyromonas gingivalis. Treatment of chronic periodontitis can be done by scaling and root planing and supporting therapy by using mouthwash such as Chlorhexidine gluconate 0.2% which is the gold standard in the treatment of periodontal disease. Chlorhexidine gluconate 0.2% has disadvantages so that nowadays research on herbal plants is being done to find alternative medicines that are more effective. Ramania (Bouea machropylla Griffith) leaf contains flavonoids that have antibacterial properties. Objective: To analyze the antibacterial effectivity of the flavonoid fraction of Ramania leaf extract against Porphyromonas gingivalis that causes chronic periodontitis. Method: True experimental study and post-test with control group design consisting of 5 treatment groups, namely flavonoid fraction of ramania leaf extract with concentrations of 0.1%, 0.3%, and 0.5%, chlorhexidine gluconate 0.2% as a control positive and aquadest as a negative control. Each group was repeated 6 times. Antibacterial tests using the dilution method with inhibitory rates calculated using a UV-Vis spectrophotometer and killing rates were calculated using a Colony Counter. Results: The average difference in absorbance values obtained inhibitory rates at concentrations of 0.1%, 0.3%, and 0.5%. One Way Anova Test showed a significance value of 0,000 (p < 0.05). The average number of colonies after 24 hours incubation showed the results of a kill rates in the concentration group of 0.3%, 0.5%, and positive control. The Kruskal Wallis test showed a significance value of 0,000 (p < 0.05). Conclusion: The minimum inhibitory concentration (MIC) was obtained at a concentration of 0.1% and the minimum bactericidal concentration (MBC) was obtained at 0.3% concentration. Keywords: Flavonoid Fraction, MIC, MBC, Porphyromonas Gingivalis, Ramania Leaf Extract.

Chlorhexidine Gluconate Bathing Program to Reduce Health Care–Associated Infections in Both Critically Ill and Non–Critically Ill Patients

Background Critical care nurses take care of patients with complicated, comorbid, and compromised conditions. These patients are at risk for health care–associated infections, which affect patients’ lives and health care systems in various ways. Objective To gauge the impact of routinely bathing patients with 4% chlorhexidine gluconate solution on the incidence of health care–associated infections in a medical-surgical intensive care unit and a postoperative telemetry unit; to outline the framework for a hospital-wide presurgical chlorhexidine gluconate bathing program and share the results. Methods A standard bathing protocol using a 4% chlorhexidine gluconate solution was developed. The protocol included time studies, training, monitoring, and surveillance of health care–associated infections. Results Consistent patient bathing with 4% chlorhexidine gluconate was associated with a 52% reduction in health care–associated infections in a medical-surgical intensive care unit. The same program in a postoperative telemetry unit yielded a 45% reduction in health care–associated infections. Conclusion A comprehensive daily 4% chlorhexidine gluconate bathing program can be implemented with standardized protocols and detailed instructions and can significantly reduce the incidence of health care–associated infections in intensive care unit and non–intensive care unit hospital settings.