Effect of Chlorhexidine on Causative Microorganisms of Infective Endocarditis in Oral Cavity

Chlorhexidine이 구강내 감염성 심내막염 유발 균주에 미치는 영향

Bacteremia occurs in a wide variety of clinical procedures in oral cavity. Reduction of the number of causative microorganisms of infective endocarditis in oral cavity by local administration of antimicrobial agents decreases the magnitude of bacteremia and possibility of infective endocarditis. The effects of chlorhexidine on Streptococcus sanguis, Streptococcus mitis, Streptococcus mutans, Streptococcus oralis, Streptococcus gordonii, Staphylococcus aureus, and Staphylococcus epidermis were investigated by measurement of turbidity. The effects of 0.1% chlorhexidine gargling for 7 days on oral bacterial flora, total streptococci, S. mutans, S. aureus, and S. epidermis in whole saliv a of 7 healthy human subjects, were investigated by measurement of Colony Forming Units (CFU). The obtained results were as follows : 1. Chlorhexidine showed significant antimicrobial effects on Streptococcus snaguis, Streptococcus mitis, Streptococcus mutans, Streptococcus oralis, Streptococcus gordonii, Staphylococcus aureus, and Staphylococcus epidermis. However, the effects on S. sanguis and S. gordonii were not apparent compared with other microorganisms. 2. Oral gargling of 0.1% chlorhexidine decreased the CFU values of normal oral bacterial flora, total streptococci, S. mutans, S. aureus, and S. epidermis in whole saliva. The antimicrobial effects were significant after 4 days of chlorhexidine gargling. 3. Local antimicrobial administration in addition to systemic antibiotic prophylaxis can be highly recommended as an effective adjunct regimen for prevention of infective endocarditis.