0.25-PERCENT CHLORHEXIDINE GLUCONATE GEL - A PROTECTIVE TOPICAL MICROBICIDE

Background and Objectives: An estimated 4 million new cases of chlamyd ial infection occur each year. This experiment assessed the effects of a vaginally applied gel formulation of 0.25% chlorhexidine gluconate on chlamydial infection and on the vaginal ecosystem, Study Design: Tw elve monkeys were treated with a single application of 0.25% chlorhexi dine gluconate. These animals were assessed for changes in vaginal flo ra before and at 30 minutes, 1 day, and 2 days postapplication by micr obiologic analysis. Cervical and vaginal tissues were assessed by colp oscopy at each time point, Five monkeys received a single application of 0.25% chlorhexidine gluconate gel followed (30 minutes) by a cervic al inoculation with Chlamydia trachomatis. Four monkeys were inoculate d with Chlamydia only, Cervicovaginal tissues were assessed via modifi ed colposcopy, vaginal swabs were collected for assessment of vaginal flora, and cervical swabs were collected for detection of Chlamydia (c ulture/ligase chain reaction) at baseline and days 1, 2, and 7 postino culation, Results: Changes in vaginal flora were minimal in all monkey s. Application of 0.25% chlorhexidine gluconate did not affect adverse ly vaginal colonization by lactobacilli. All chlamydial infection cont rol monkeys were infected, whereas none of the five monkeys pretreated with chlorhexidine gluconate were positive for C, trachomatis by cult ure or ligase chain reaction, Colposcopic observations remained largel y unchanged in all groups, Conclusions: A 0.25% chlorhexidine gluconat e gel was protective against chlamydial infection in all animals teste d, had no adverse effect on the vaginal flora, and had minimal effect on cervicovaginal tissues after a single application.