WHO has been made aware of multiple, recent reports of eye injury, including blindness, with the use of chlorhexidine gluconate 7.1%, in nine countries in sub Saharan Africa.
Chlorhexidine gluconate (CHX), available as an aqueous solution or as a gel (delivering 4% chlorhexidine), is used in umbilical cord care. WHO recommends daily chlorhexidine (4%) application to the umbilical cord stump during the first week of life for newborns who are born at home in settings with high neonatal mortality. Clean, dry cord care is recommended for newborns born in health facilities, and at home in low neonatal mortality settings. Use of chlorhexidine in these situations may be considered only to replace application of a harmful traditional substance such as cow dung to the cord stump. The use of CHX is being implemented in many countries (South Asia and sub-Saharan Africa) as part of a package of essential newborn interventions to reduce the incidence of omphalitis.
CHX causes serious harm if mistakenly applied to the eyes, resulting in severe eye injuries. Over forty (40) cases of such incorrect administration are recorded, either as media reports, or in the literature, since 2015. Injuries associated with both the liquid and gel (ointment) formulations have been reported when CHX was mistaken for eye drops or ointments.
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