Making a choice of catheterisation gel and the role of chlorhexidine

One trust's rationale for choosing a lubrication gel for use in catheterisation

Current NHS policy is to reduce the number of catheter-associated urinary tract infections (CAUTIs). To achieve this, guidance suggests reducing the use of catheterisation as much as possible. For those patients requiring catheterisation, Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH) ensured that a medicinal anaesthetic, antiseptic lubricant containing chlorhexidine and lidocaine was used for all catheterisations. Between 2011 and 2018 the Trust reduced CAUTIs by around 50%. This article discusses catheterisation, national policy in reducing CAUTIs, and how NNUH achieved this reduction.

Chlorhexidine Allergy: On the Rise and Often Overlooked

PURPOSE OF REVIEW

In recent years, the risk of allergy to chlorhexidine is increasingly recognised. In this review, we discuss why the allergy is so easily overlooked and point out several preventative initiatives that can minimise the risk of both chlorhexidine sensitisation and allergy development and accidental re-exposure in patients with chlorhexidine allergy. Testing for chlorhexidine allergy is also discussed.

RECENT FINDINGS

Numerous reports have been published from many different specialties. Symptoms range from mild skin symptoms to life-threatening anaphylaxis. Testing for chlorhexidine allergy is based on skin testing and in vitro testing. Recently, it was found that both skin prick testing and specific IgE have high sensitivities and specificities. This review gives an overview of chlorhexidine allergy with a special focus on preventative initiatives and testing.