If a patient has a known allergy to chlorhexidine, which skin prep is typically used as an alternative?

• A. Soap and water.
• B. Povidone-iodine.
• C. Ethanol alone.
• D. Chlorhexidine-alcohol is preferred.

Answer: (B)

When chlorhexidine allergy is present, the typical alternative for preoperative skin antisepsis is povidone-iodine. It provides broad antimicrobial coverage against bacteria, viruses, and fungi and tends to offer rapid onset with some residual activity on the skin, helping to lower microbial load during the procedure. Ethanol alone, while effective, lacks the sustained antiseptic effect and comprehensive skin coverage needed for a surgical prep. Soap and water is a cleansing step but does not provide the same level of antiseptic protection as an antiseptic agent for surgical sites. Chlorhexidine-alcohol would be avoided because of the allergy.