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Serial hexachlorophene blood levels in the premature infant
Insights
Premature infants absorb more hexachlorophene through the skin than full-term infants. Blood concentrations peaked 2-4 days after a single 5ml pHisoHex wash, leading to revised usage guidelines for newborns.
Area of Science:
- Neonatal toxicology
- Dermal absorption studies
- Pediatric dermatology
Background:
- Hexachlorophene, a topical antiseptic, has been used in infant hygiene.
- Concerns exist regarding the systemic absorption of hexachlorophene, particularly in vulnerable infant populations.
Purpose of the Study:
- To quantify hexachlorophene blood concentrations in premature infants following dermal application.
- To compare hexachlorophene absorption rates between premature and full-term infants.
- To inform clinical guidelines for hexachlorophene use in neonates.
Main Methods:
- Serial blood sampling from seven premature infants after a single wash with 5ml of pHisoHex.
- Analysis of blood samples to determine hexachlorophene concentration (µg/ml).
Main Results:
- Peak blood hexachlorophene concentrations ranged from 0.75-1.20 µg/ml, occurring 2-4 days post-application.
- Dermal absorption of hexachlorophene was significantly greater in premature infants compared to full-term infants.
Conclusions:
- The study confirms higher dermal absorption of hexachlorophene in premature infants.
- Clinical practice has been updated: hexachlorophene use for infants <2kg birth weight is discontinued.
- pHisoHex application is limited to a single 5ml wash for infants >2kg birth weight.
Abstract:
The concentration of hexachlorophene was determined in serial blood samples taken from seven premature infants washed with pHisoHex. Results indicated that after a single wash with 5ml of pHisoHex, blood concentrations reached a maximum of 0.75-1.20mug/ml two to four days after application. The results obtained in this study confirm that the dermal absorption of hexachlorophene is greater in premature than in full-term infants. Use of hexachlorophene for infants. Use of hexachlorophene for infants of birth weight less than 2kg has now been discontinued at Queen Mary Hospital and the amount of pHisoHex used in the initial toileting of infants with birth weight more than 2kg has been limited to a single application of 5ml.