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PubMed2006

Increase in catheter insertion-site infections associated to the introduction of a substandard competitive antiseptic.

The introduction of low-cost competitive antiseptic products may offer savings, but, unfortunately, their quality control is poor in many developing countries. The use of a new brand of idopovidone solution, used routinely for catheter insertion-site cleaning, was associated with a 55% increase in catheter insertion-site infection per 100 active catheters, returning to usual after the product was recalled. The new brand of iodopovidone solution had less free iodine (.76%) and lower pH (2.7) than required by local standards (pH 3-6.5). Use of substandard antiseptics in developing countries, because of poor quality control, is a risk for patients and results in increased health services expenses and burden of work.

Anti-Infective Agents, Local↗

PubMed2006

N-Chlorotaurine and ammonium chloride: an antiseptic preparation with strong bactericidal activity.

The bactericidal activity of the endogenous antiseptic N-chlorotaurine (NCT) is significantly enhanced in the presence of ammonium chloride which induces the formation of monochloramine (NH(2)Cl) whose strong bactericidal activity is well known. In this study the properties of NCT plus ammonium chloride have been investigated. The reaction of active chlorine compounds like chloramine-T (N-chlorotoluene-sulfonamide sodium), chloroisocyanuric acid derivatives, hypochlorites (NaOCl, CaOCl(2)) with ammonium chloride did not stop at the stage of monochloramine, and the pungent smelling by-products di- and trichloramine, NHCl(2) and NCl(3), were also formed. This was not the case with NCT where only monochloramine was generated. The equilibrium constant of the reaction of NCT with ammonium was found to be [Formula: see text] , which allows to estimate the equilibrium concentration of monochloramine in aqueous solutions of NCT and ammonium chloride. At concentrations each ranging between 0.01% and 1.0% it comes to [NH(2)Cl]=3.5-254 ppm. As an unexpected result the monochloramine containing formulation turned out to be most stable in plain water without buffer additives. Quantitative killing assays revealed complete inactivation of 10(6) to 10(7)CFU/mL of seven bacterial strains by 0.1% NCT plus 0.1% ammonium chloride within 5 min, while with plain 0.1% NCT an incubation time of 2-4h was needed to achieve the same effect. The highly significant increase of bactericidal activity (200-300-fold) could be assigned to the presence of monochloramine which could be isolated by vacuum distillation. Aqueous solutions of NCT and ammonium chloride provide a highly effective and well tolerable antiseptic preparation appropriate to a treatment cycle of at least 1 month if stored in the refrigerator.

Ammonium Chloride↗

PubMed2006

Comparison of two alcohol-based surgical scrub solutions with an iodine-based scrub brush for presurgical antiseptic effectiveness in a community hospital.

The antiseptic effectiveness and acceptability of a commercial alcohol-based waterless (ABWL) and an alcohol-based water-aided (ABWA) scrub solution were compared with a brush-based iodine solution (BBIS) under conditions encountered in community hospital operating rooms. This randomized partially blinded study was based on guidelines from the American Society for Testing and Methods. The three scrub solutions were compared for antimicrobial efficacy, using criteria within the Food and Drug Administration's Tentative Final Monograph for Healthcare Antiseptic Products (FDA-TFM), and for participants' acceptance of the products. Volunteer surgical staff that worked daily in the same operating room for the entire duration of the study were enrolled. In total, 1126 surgical scrub procedures were performed over the duration of the study. Only the ABWL met all of the FDA-TFM criteria. The BBIS performed better than both of the alcohol-based solutions at the end of Day 1 (P=0.03), but the ABWL was more efficacious than the ABWA and the BBIS at the end of Days 2 and 5 (P=0.02 and 0.01, respectively). When colony-count reductions were compared over the entire duration of the study, there was no significant difference between the three solutions (P=0.2). The participants found the ABWL easiest to use (P<0.001), with the fewest adverse effects on skin (P=0.007), and it was their preferred product (P<0.001). Although both of the commercially available alcohol-based solutions may be considered as acceptable alternatives to the BBIS for presurgical antisepsis, the ABWL was found to have significantly higher user acceptability.

Anti-Infective Agents, Local↗

PubMed2006

Antiseptic effect of a novel alcohol-free mouthwash: a convenient prophylactic alternative for high-risk patients.

We developed an efficacious and non-irritant mouthwash that is alcohol-free and that has a low concentration of chlorhexidine, in order to be used for preventing oral cavity infections in immunocompromised and cancer patients. The novel mouthwash solution was tested for its antimicrobial efficacy against both free floating (planktonic) and the biofilm forms of Candida albicans. The solution was also tested against Klebsiella pneumoniae, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus (MRSA), using a modification of a previously published method. The activity of the novel mouthwash was also compared with that of three commercially available mouthwashes. The experimental mouthwash showed efficacy against C. albicans, both in free-floating form and in biofilm. With higher concentration of chlorhexidine, the solution was also efficacious in inhibiting the growth of K. pneumoniae, P. aeruginosa, and MRSA. The antiseptic activity of the alcohol-free mouthwash against other bacterial organisms and C. albicans was comparable to other commercially available alcohol-based mouthwash solutions. A novel alcohol-free mouthwash solution, that has low concentration of chlorhexidine, showed antiseptic effect against planktonic and biofilm forms of C. albicans and against K. pneumoniae, P. aeruginosa, and MRSA.

Anti-Infective Agents, Local↗

PubMed1984

The corneal toxicity of presurgical skin antiseptics.

In a study of the corneal toxicity of some commonly used presurgical skin antiseptics, we used biomicroscopy, corneal pachymetry, healing studies, and electron microscopy to compare tincture of iodine (2% iodine, 2.35% sodium iodine, and 46% ethanol), Hibiclens (4% chlorhexidine and 4% isopropyl alcohol with detergent), pHisoHex (3% hexachlorophene and detergent), Lavacol (70% ethanol), 7.5% povidone iodine scrub (with a detergent), and 10% povidone iodine solution (without a detergent) in rabbits. Five minutes after application, moderate corneal epithelial edema was noted in all groups except the saline control group. After three hours there was marked corneal de-epithelialization, conjunctival chemosis, and anterior stromal edema in all groups except those treated with 10% povidone iodine solution and 0.9% sodium chloride. After one week all corneas had returned to normal. Accidental instillation of 7.5% povidone iodine scrub into the tear film of a 33-year-old man resulted in almost immediate chemical chemosis despite prompt irrigation, demonstrating the corneal toxicity of this substance. These results indicated that a 10% povidone iodine solution without detergent causes minimal corneal toxicity whereas the other presurgical skin antiseptics tested are toxic to the cornea.

Adult↗

PubMed2002

Excision and primary closure of pilonidal sinus using a drain for antiseptic wound flushing.

BACKGROUND: In the case of pilonidus sinus treated with primary intention surgery the uneventful healing is still difficult to obtain, as indirectly proven by the number of different procedures that have been suggested, such as cyst excision with or without primary closure, excision followed by marsupialisation, and excision followed by skin flap transposition. The procedure described here involves excision and primary closure, with a drain being used to flush the operative cavity with an antiseptic solution. METHODS: Two hundred and forty-three patients (173 men and 70 women) were treated by excising the pilonidal sinus and placing a 12F suction drain at the base of the wound, with its tip being brought out in the left gluteal region at least 5 cm laterally to the lower end of the suture. Suction was stopped on the first postoperative day and the drain was cut just above the skin. On day 2, a 5F catheter was inserted through the drain and the cavity was flushed with an antiseptic solution followed by sterile saline solution; the same treatment was repeated on days 4 and 6. The drain was removed on day 8 or 9, some of the stitches on day 8 or 9 and the rest on day 9 or 10. The surgery was performed on a day hospital basis in 207 cases; the remaining 36 were hospitalized overnight and discharged on the following day. RESULTS: Healing was always by first intention, with none of the 243 patients experiencing any complications. The postoperative follow-up now ranges from 5 to 15 years, and there have not been any recurrences. CONCLUSIONS: The drainage of blood from the bottom of the wound and the use of antiseptic/saline flushing are essential for primary intention healing and the avoidance of recurrences.

Adolescent↗

PubMed1982

Urinary tract antiseptics.

The urinary tract antiseptics discussed herein have specific advantages and disadvantages. All share a pharmacokinetic fate that makes them effective in treating acute, uncomplicated symptomatic bladder bacteriuria. Nitrofurantoin appears to be the most versatile because it is effective against upper tract infection, recurrent bacteriuria, and as a long-term suppressive agent in children and pregnant patients with only a low incidence of the development of resistance. Methenamine, when used with proper understanding of it pharmacokinetic behavior, is also effective in females with uncomplicated recurrent bacteriuria including those with multiply resistant pathogens, as well as a prophylactic agent in males with recurrent infection. There is little evidence that methenamine combined with mandelic or hippuric acid confers any pharmacologic or therapeutic advantage over the use of methanamine base alone. Nalidixic acid and oxolinic acid, in addition to effectiveness in treating uncomplicated acute lower urinary tract infections, may be effective in some patients with recurrent infections, but requires careful sensitivity monitoring of pathogens for the development of resistance. Finally, in a society whose economic pressures are such that it may not be cost-effective to use sulfamethoxazole-trimethoprim for urinary tract prophylaxis--unless two or more acute infections occur per year--the use of these urinary antiseptics may offer increasing advantages now and in the future.

Anti-Infective Agents, Urinary↗

PubMed1975

Gloved hand as applicator of antiseptic to operation sites.

A 95% ethanol solution containing 0-5% chlorhexidine digluconate caused a significantly greater mean reduction in skin bacteria (99-9% plus or minus 0-024) when rubbed by a gloved hand on to the skin of one hand for two minutes than when applied to the same area for the same time with the traditional gauze applicator for operation sites (90-7% plus or minus 2-12). The latter reduction, however, was greater than that reported in five previous experiments in which application of the same solution for the same time to two hands gave mean reductions varying from 79% to 84%. An aqueous solution and a 70% alcoholic solution of chlorhexidine also gave significantly greater reduction (and alcoholic povidone iodine almost significantly greater reduction) when applied by a gloved hand than on gauze. It is inferred that the effectiveness of skin disinfection depends both on the antiseptic used and on the manner of application, and varies with the amount of friction used in applying the antiseptic. Further studies on disinfection of the surgeon's hands with 0-5% chlorhexidine in 95% alcohol rubbed on and allowed to dry have supported its value and acceptability; the mean bacterial counts of washings from gloves of surgeons after operations were lower after the use of this method than after other preoperative preparations of the hands.

Bacteria↗

PubMed1998

Antiseptics and disinfectants.

Germicidal agents used as antiseptics and disinfectants play an important role in the control of infection in the veterinary patient. Critical to the proper use of germicidal agents in or around the veterinary patient is knowledge of efficacy and contraindications. The key to proper use of antiseptics and disinfectants is using the proper germicidal agent under conditions that maximize success and minimize complications. Although there are a number of germicidal agents commercially available, effective antisepsis and disinfection can be achieved through use of a few effective, yet safe germicides.

Animals↗

PubMed2003

Assessment of Acinetobacter baumannii susceptibility to antiseptics and disinfectants.

Disinfection and antisepsis are of primary importance in controlling outbreaks of Acinetobacter baumannii, a nosocomial pathogen that frequently shows multiple antibiotic resistance. In this study we assessed the susceptibility of nine A. baumannii strains isolated during a sustained intensive care unit outbreak, to several antiseptics and disinfectants based on European Standards. While the tested strains showed diverse antibiotic resistance patterns, they were equally sensitive to the biocides assessed in vitro. We observed neither evidence of development of resistance to biocides over time, nor a correlation between resistance to antibiotics and a decreased susceptibility to antiseptics or disinfectants.

Acinetobacter Infections↗

PubMed1985

Experimental and preliminary clinical experience with absorbable calcium phosphate granules containing an antibiotic or antiseptic for the local treatment of osteomyelitis.

Experimental studies on dogs with staphylococcal osteomyelitis showed that it is possible to reduce florid bone suppuration by the use of hydroxyapatite granules containing an antibiotic or antiseptic. In our series the use of flucloxacillin hydroxyapatite granules was superior to other treatment methods. Twelve patients were treated with thorough sequestrectomy, reliable wound closure and suitable stabilization supplemented with an implant of antibiotic or antiseptic hydroxyapatite granules, and an autologous spongiosa graft for large bone cavities or for discontinuity between the bone ends. The results of this preliminary study showed the treatment to be effective.

Adolescent↗

PubMed1998

Antimicrobial activity of antiseptic-coated orthopaedic devices.

Antimicrobial coating of medical devices, including fracture fixation devices, has evolved as a potentially effective method for preventing device-related infections. We examined the in vitro antimicrobial activity of titanium cylinders coated with the antiseptic combination of chlorhexidine and chloroxylenol. The coated devices provided zones of inhibition against Staphylococcus epidermidis, S. aureus, Pseudomonas aeruginosa, Escherichia coli and Candida albicans, at baseline and up to 8 weeks after incubation of the coated cylinders in human serum at 37 degrees C. This durable antimicrobial activity was attributed to the relatively slow leaching of chlorhexidine and chloroxylenol from the coated cylinders as measured by high-performance liquid chromatography. These results suggest that antiseptic-coated orthopaedic devices may provide broad-spectrum and durable antimicrobial protection against device-related infection.

Anti-Infective Agents, Local↗

PubMed1995

Clinical studies on the use of antibiotic- and antiseptic-bonded catheters to prevent catheter-related infection.

Central venous catheter-related infections are common despite adherence to hygienic guidelines for insertion and maintenance of these devices. It has been suggested that coating of intravascular catheters with antimicrobial agents, either antibiotics or antiseptics, could reduce the incidence of catheter-related infections. Recent studies have demonstrated the efficacy of antibiotic-coated and antiseptic-impregnated catheters in reducing bacterial colonisation and infection. Preliminary results of pilot studies indicate that silver impregnation of intravascular catheters may be effective. At present, these antimicrobial-bonded catheters seem to be an important addition to the choice of preventive strategies, but their definitive role and possible disadvantages such as induction of resistance still have to be clearly delineated.

Anti-Infective Agents↗

PubMed2006

Antiseptics, iodine, povidone iodine and traumatic wound cleansing.

Wound cleansing is an integral part of the management of acute traumatic wounds. There is consensus that it reduces infection rates. However, the choice of cleansing agent remains controversial, especially the use of antiseptics has been questioned. This article reviews the current literature on the use of antiseptics particularly povidine iodine in traumatic wound cleansing and discusses the beneficial and harmful effects of such practice.

Acute Disease↗

PubMed1976

An evaluation of antiseptics used for hand disinfection in wards.

The antibacterial effectiveness of hand antiseptics commonly used in wards was studied by laboratory and in-use tests and their acceptability assessed by means of a questionnaire passed to hospital staff. To determine the immediate and long-term antibacterial effects of the preparations the in-use tests were performed by groups of students. The greatest immediate reduction in bacterial counts on hands was obtained by products containing chlorhexidine. The long-term antibacterial effect was recorded with emulsions containing 3% hexachlorophane, 2% Irgasan CF3R or 4% chlorhexidine when used constantly on several consecutive days. Considerable discrepancies were recorded in the antibacterial effectiveness of some preparations when comparing laboratory and in-use test results. Therefore it is suggested that antiseptics should be tested by in-use tests which more closely resemble practical conditions before their use, or further trial, in hospital.

Anti-Infective Agents, Local↗

PubMed1994

Topical antiseptic mouthwash in oncological surgery of the oral cavity and oropharynx.

A multivariant analysis of the value of the use of a pre-operative topical antiseptic mouthwash to reduce the incidence of post-operative wound complications in 106 consecutive patients undergoing head and neck surgery involving the oral cavity or oropharynx was carried out at the University of Iowa, Department of Otolaryngology--Head and Neck Surgery. An oral presentation employing povidone-iodine solution was used for 43 patients. The remaining 63 patients studied received no oral presentation. Unfavourable wound outcome was not associated with age, sex, presence and condition of teeth, or serious pre-existing medical illnesses. A significant correlation was found between post-operative wound breakdown and type of closure, stage of disease, and previous operation or radiotherapy. The use of an oral preparation correlated significantly with favourable wound outcome independent of all other variables (p < 0.01). Our data support the use of a topical antiseptic mouthwash to reduce the incidence of post-operative wound complications in surgery of the oral cavity and oropharynx.

Aged↗

PubMed2006

Partitioning, persistence, and accumulation in digested sludge of the topical antiseptic triclocarban during wastewater treatment.

The topical antiseptic agent triclocarban (TCC) is a common additive in many antimicrobial household consumables, including soaps and other personal care products. Long-term usage of the mass-produced compound and a lack of understanding of its fate during sewage treatment motivated the present mass balance analysis conducted at a typical U.S. activated sludge wastewater treatment plant featuring a design capacity of 680 million liters per day. Using automated samplers and grab sampling, the mass of TCC contained in influent, effluent, and digested sludge was monitored by isotope dilution liquid chromatography (tandem) mass spectrometry. The average mass of TCC (mean +/- standard deviation) entering and exiting the plant in influent (6.1 +/- 2.0 microg/L) and effluent (0.17 +/- 0.03 microg/ L) was 3737 +/- 694 and 127 +/- 6 g/d, respectively, indicating an aqueous-phase removal efficiency of 97 +/- 1%. Tertiary treatment by chlorination and sand filtration provided no detectable benefit to the overall removal. Due to strong sorption of TCC to wastewater particulate matter (78 +/- 11% sorbed), the majority of the TCC mass was sequestered into sludge in the primary and secondary clarifiers of the plant. Anaerobic digestion for 19 days did not promote TCC transformation, resulting in an accumulation of the antiseptic compound in dewatered, digested municipal sludge to levels of 51 +/- 15 mg/kg dry weight (2815 +/- 917 g/d). In addition to the biocide mass passing through the plant contained in the effluent (3 +/- 1%), 76 +/- 30% of the TCC input entering the plant underwent no net transformation and instead partitioned into and accumulated in municipal sludge. Based on the rate of beneficial reuse of sludge produced by this facility (95%), which exceeds the national average (63%), study results suggest that approximately three-quarters of the mass of TCC disposed of by consumers in the sewershed of the plant ultimately is released into the environment by application of municipal sludge (biosolids) on land used in part for agriculture.

Carbanilides↗

PubMed2003

Experimental evaluation of antifungal and antiseptic agents against Rhodotorula spp.

We studied the susceptibility of 21 strains of Rhodotorula rubra and nine strains of R. glutinis to eight antifungals and tested eight antiseptic agents on one strain of R. rubra. The tested strains were susceptible to ketoconazole, 5-fluorocytosine, amphotericin B, and nystatin, intermediate to econazole and resistant to fluconazole, itraconazole and miconazole. After 5-min contact, six of the eight antiseptic agents tested showed a fungicidal activity on the tested R. rubra strain.

Amphotericin B↗