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PubMed2006

Reproducibility and workability of the European test standard EN 12791 regarding the effectiveness of surgical hand antiseptics: a randomized, multicenter trial.

OBJECTIVES: To evaluate the reproducibility and workability of the in vivo test model of the European test standard EN 12791 regarding the effectiveness of surgical hand antiseptics and, as a secondary objective, to evaluate the power of the model to discriminate between the effectiveness of various formulations of surgical hand antiseptics. DESIGN: Prospective, randomized, multicenter study with a Latin square design. SETTING: Five laboratories at 2 universities, 2 disinfectant manufacturers, and 1 private testing institution. PARTICIPANTS: Twenty healthy adults in each laboratory. INTERVENTION: Surgical hand antisepsis was performed by scrubbing with chlorhexidine gluconate 4% detergent (CHG) or by rubbing the hands with propan-2-OL (70% by volume; Iso 70) or ethanol 85% (E 85); rubbing the hands and forearms for 3 minutes with propan-1-OL (N 60) was used as the reference disinfection procedure. We deliberately chose to use these antiseptics at the given concentrations because they were intended to cover the range of typical antiseptics submitted for approval according to EN 12791. METHODS: In once-weekly tests, the immediate effects of the 4 antiseptics were established according to the method laid down in EN 12791 by assessing the release of skin flora from the fingertips as viable bacteria counts per milliliter of sampling fluids before treatment and viable bacteria counts immediately after treatment, separately for both hands, such that after 4 weeks each volunteer had used every formulation once. RESULTS: The mean log reduction factor (RF) for the release of bacterial skin flora (the log RF was calculated as the log count before treatment minus the log count after treatment) and corresponding standard deviations for the 4 hand antisepsis formulations were as follows: for CHG, 1.1+/-0.3 colony-forming units (cfu) per milliliter of sampled fluid; for Iso 70, 1.7+/-0.3 cfu/mL; for E 85, 2.1+/-0.3 cfu/mL; and for N 60, 2.4+/-0.4 cfu/mL. The differences between these values proved significant (P<.001) by analysis of variance and in Tukey's "honestly significantly different" (HSD) post hoc test. Although, with regard to their immediate antibacterial activity, the same ranking of these antiseptics was found at all laboratories, the levels of efficacy were significantly different across laboratories (P<.001); no statistical difference was found between left and right hands (P>.01). Relating the log RF values of the other 3 formulations to those of the reference formulation (N 60) abolished differences between laboratories (P=.16); in addition, the interclass correlation coefficient decreased from 9.1% to 4.5%. With 20 volunteers, a minimum difference of 0.47 log between the mean log RFs of the reference formulation and an inferior test formulation will be detected as significant at an alpha of .05 (1-sided) and a 1- beta value of .8. CONCLUSION: The test method described in EN 12791 yielded the same conclusion on the effectiveness of the tested formulations in every laboratory and proved, therefore, reproducible and workable.

2-Propanol↗
PubMed1989

In vivo standardization of cutaneous bactericidal activity of antiseptics by using monoxenic hairless mice.

This study was designed to investigate the bactericidal activities of antiseptics on the cutaneous flora of hairless mice monoxenic to Staphylococcus epidermidis, Staphylococcus aureus, or Pseudomonas aeruginosa in vivo. A standardized method for testing such antiseptics to compare their bactericidal effectiveness in humans in described. Seven antiseptics belonging to seven different chemical groups (iodine derivatives, alcohols, mercury compounds, quaternary ammonium salts, biguanides, phenols, and carbanilides) were used as recommended by the manufacturers (conditions of contact or prolonged contact time followed by washing with distilled water). Germfree hairless mice were infected with various bacterial strains by gastric intubation, producing levels of about 10(3) CFU/cm2 of skin. The antiseptic under test was placed on the right or left side of the ventral region. The contralateral side served as a control. In order to standardize the method, a number of crucial parameters were carefully controlled: the amount of antiseptic applied, the area of skin treated, the duration of treatment, and the washing procedure. Skin samples were obtained by cutaneous biopsy, which effectively removed all the bacteria along with the sample. The bacterial populations were counted before and after application of the antiseptic. Reductions of between 0.5 and 1.9 log units were obtained; these are comparable to those observed in humans. The standardization of our procedure and the use of animals with a strictly controlled flora eliminated much of the variability and sources of error inherent in human studies. This model could be of value for the study of resistant bacterial strains responsible for nosocomial infections and for investigations of damaged skin.

Animals↗
PubMed2002

Bactericidal activities of commonly used antiseptics against multidrug-resistant mycobacterium tuberculosis.

Seventeen clinical isolates of Mycobacterium tuberculosis were selected in order to study the bactericidal activities against drug-resistant M. tuberculosis. The effects of different antiseptics against multidrug-resistant M. tuberculosis (MDR-TB) were examined. Each of the test strains was cultured on the surface of an agar slant containing Löwenstein-Jensen medium. 0.05 ml of the bacillary suspension was poured into a test tube, and 0.45 ml of various antiseptics was added. After the bacilli had been exposed to the antiseptic solution with 2% human serum for various periods of incubation time, the antiseptic was inactivated by addition of 0.45 ml neutralizer, a mixture containing 10% Tween 80, 3% soybean lecithin and 0.5% sodium thiosulfate. As the results, povidone-iodine (PVP-I) at a concentration of 0.2% killed 99.9% or more of all strains tested within 30 s. All of the strains tested with PVP-I were killed almost completely within 60 s. There was no difference in bactericidal activities of PVP-I between standard strain H37Rv and MDR-TB. 99.9% or more of all strains tested were killed after exposure to 1.0% cresol for 60 s. In the case of cresol however, the exposure time of 30 s was not enough to get satisfactory effects. 2.0% glutaraldehyde needed 5 min to kill 99.99% or more of the bacilli tested, and 0.2% alkyldiaminoethylglycine hydrochloride required 60 min to do so. The results of bactericidal activities of common antiseptics against MDR-TB were similar to those against H37Rv. We conclude that the commercially available PVP-I product is a useful antiseptic against MDR-TB similar to other M. tuberculosis.

Anti-Infective Agents, Local↗
PubMed2002

In vitro antiseptic susceptibility of clinical isolates from nosocomial infections.

To evaluate the susceptibility of a large number of strains to various antiseptics, we elaborated a simple, qualitative broth turbidity method in which we could quickly judge the efficacy visually. For this method, we prepared a modified neutralizer broth, consisting of trypticase soy broth containing 15% Tween 80, 1% soybean lecithin and 0.5% sodium thiosulfate. The susceptibilities of Serratia marcescens No. 26 to 4 antiseptics obtained from the turbidity method showed a good agreement with those obtained from the colony-counting method; the 4 antiseptics tested were povidone-iodine (PVP-I), chlorhexidine gluconate (CHG), benzalkonium chloride (BAC) and alkyldiaminoethylglycine hydrochloride (AEG). Both PVP-I and BAC had complete efficacy in 0.5 min against all isolates tested [100 isolates of S. marcescens, 103 of Klebsiella pneumoniae, 99 of Pseudomonas aeruginosa, 19 of Alcaligenes faecalis and 30 of A. xylosoxidans subsp. xylosoxydans (A. xylosoxydans)]. In contrast, the effectiveness of CHG was weak compared with PVP-I, BAC and AEG. Strong resistance against AEG was noted even after 3-min exposure in 1 isolate each of A. faecalis and A. xylosoxydans. It is concluded that the turbidity test is a simple and accurate method to evaluate susceptibility to various antiseptics and that it is suitable for a screening of a large number of strains. Among the 4 antiseptics tested, PVP-I and BAC showed a consistently high activity against all isolates, confirming PVP-I and BAC to be clinically useful antiseptics.

Anti-Infective Agents, Local↗
PubMed1997

Investigation on the efficacy of povidone-iodine against antiseptic-resistant species.

The bactericidal activity of commonly used antiseptics against clinical isolates was determined. It is noteworthy that povidone-iodine (PVP-I) solution showed high bactericidal activity against all of the test strains after 30 s of exposure. However, in the case of chlorhexidine gluconate (CHG), residual bacteria were observed in most species. Next, acquisition of resistance to antiseptics was examined, and it was found that remarkable increases in MICs were seen for CHG and alkyldiaminoethylglycine hydrochloride. The strains which acquired resistance against one antiseptic showed cross-resistance to all antiseptics except for PVP-I. As for bactericidal activity against biofilm, no viable cells were seen after a 10-min exposure to PVP-I solution. No decrease in viable cell count was seen even after a 60-min exposure to any of the other antiseptics. PVP-I showed high activities in all the tests conducted in this study. Thus, PVP-I was confirmed to be a clinically useful antiseptic.

Anti-Infective Agents, Local↗
PubMed2004

Eradication of methicillin-resistant Staphylococcus aureus with an antiseptic soap and nasal mupirocin among colonized patients--an open uncontrolled clinical trial.

BACKGROUND: Aim of the study was to determine the clinical efficacy of a new antiseptic liquid soap (Stellisept scrub), based on the combination of undecylenamidopropyltrimonium methosulphate (4%) and phenoxyethanol (2%), for eradication of MRSA among colonized patients who do not receive antibiotic therapy. METHODS: Over two years 50 MRSA patients in 6 hospitals were observed. Treatment was defined as the daily application of Stellisept scrub for the antiseptic body and hair wash (at least 60 s) in combination with nasal mupirocin. A treatment cycle was a minimum of 5 days treatment. Screening was carried out at least 48 h after the treatment cycle was finished, with 24 h between each of the requested three or more samplings, which included the nasopharynx, groin, axilla, perineum and other MRSA-positive skin areas. RESULTS: Fifteen cases were retrospectively excluded (lack of outcome documentation, concomitant antibiotic therapy, open wounds). All 35 patients had colonization with MRSA before antiseptic treatment on the skin, in the groin (80%), the axilla (25.7%), the perineum (20%) or other skin areas (14.3%). Colonization at more than one skin sites was found in 34.3%. Nasal colonization was found in 21 of 28 patients (75%), 7 patients were without nasal screening prior to the antiseptic treatment. After one treatment cycle MRSA was eradicated in 25 patients (71.4%), after a second cycle the total eradication rate was 91.4%, after a third cycle the rate increased to 94.2%. No patient discontinued the antiseptic treatment due to dermal intolerance of the product. CONCLUSIONS: Progressive eradication of MRSA carriage was observed with the antiseptic soap and mupirocin. The eradication rate was not biased by concomitant antibiotic treatment, screening during treatment or lack of evidence for colonization in contrast to other studies with other preparations.

Journal Article↗
PubMed1981

The use of polymethylmethacrylate to compare the adsorption and staining reactions of some cationic antiseptics.

This study assessed the value of acrylic, in powder and optically clear forms, to measure the adsorption and staining properties of some cationic antiseptics. The uptake of chlorhexidine gluconate, chlorhexidine acetate, alexidine and cetyl pyridinium chloride onto acrylic powder was measured spectrophotometrically. Similarly, tea staining of perspex blocks exposed twice daily to the antiseptics and hexetidine, was measured over a 5 day period. The adsorption of chlorhexidine gluconate and acetate was similar and greater than alexidine but less than cetyl pyridinium chloride. Desorption of the adsorbed antiseptics was minimal after 48 hours soaking in water. Acid produced a variable desorption of antiseptics. Tea staining of blocks was significantly greater with antiseptic treated specimens compared to control specimens. However, staining resulting from alexidine was greater than cetyl pyridinium chloride which was greater than chlorhexidine. Hexetidine produced the least staining. Saliva treatment of specimens only increased the tea staining of control blocks. The results indicated that adsorption levels alone would not explain the differences in antiplaque and staining activity reported for the cationic antiseptics.

Adsorption↗
PubMed1989

Bacteria on stumps of amputees and the effect of antiseptics.

Amputees get stump infections usually from the natural inhabitants of the healthy skin and probably due to the unnatural environment of tight fitting sockets. The aim of the present study was to investigate the natural stump bacteria and the effect of antiseptics as well as the amputees' evaluation of such treatment. Fifteen amputees using their prostheses all day were investigated. Bacterial samplings were taken by swab technique with respect to bacteria and fungi from the stumps in the morning before prosthetic application and in the evening after a whole day's prosthetic use without antiseptic cleaning; after antiseptic cleaning with a combination of Isopropanol 45%. N-propanol 30% and N-cetyl-pyridiniumchloride 0.2% for one day: after fourteen days continuous use. The patients were asked if they liked the antiseptic and if they would like to continue to use it. Two patients did not submit bacteriological samples after the cleaning period. Before cleaning S. epidermidis, S. aureus and alpha-hemolytic streptococci were commonly found. In two instances gram negative rods were found. After the cleaning period there was a reduction of bacteria in 11 out of 13 patients. All patients liked the antiseptic and the simplicity by which the stumps and the sockets could be kept clean. The authors feel that the use of antiseptics to increase stump and socket hygiene is justified.

Adolescent↗
PubMedDate not supplied

A critical discussion of the use of antiseptics in acute traumatic wounds.

Approximately 10 million patients with traumatic wounds are treated in US emergency departments annually. The practice of wound cleansing or antiseptic management has a dichotomous history anchored in tradition and science. The merits of antiseptic fluid irrigation of traumatic wounds have received little scientific study. The purpose of this article is to critically evaluate the potential harm to patient outcome by the use of antiseptics on acute wounds. First, animal and cell culture data that describe the effects of topical antiseptics on wound healing are offered. Second, human case studies are presented to illustrate the potential harm of the indiscriminate use of antiseptics. Finally, data from previously published reviews are presented and evaluated for clinically based evidence to justify the current practice of antiseptic use in acute traumatic wounds.

Acute Disease↗
PubMed2002

Efficacy of common antiseptics against multidrug-resistant Mycobacterium tuberculosis.

OBJECTIVES: The incidence of infections caused by multidrug-resistant strains of Mycobacterium tuberculosis (MDR-TB) has been increasing. Antiseptics are frequently used to prevent mycobacterial infection. The aim of this study was to determine those antiseptics that are useful against MDR-TB. DESIGN: We evaluated bactericidal activity against clinical isolates of MDR-TB in vitro. METHOD: Thirteen strains of MDR-TB were tested against povidone-iodine (PVP-I), cresol, akyldiaminoethyl glycine hydrocloride (AEG), and glutaraldehyde. After bacilli were exposed to the antiseptic solution with 2% human serum, the disinfectant was inactivated by addition of neutraliser. RESULTS: PVP-1 at a final concentration of 0.2% killed all of the strains within 120 seconds, and PVP-I at 0.1% killed 99.9% or more bacilli within 60 seconds. Most strains were killed after exposure to 0.5% cresol at 300 seconds and to 1.0% cresol at 60 seconds; 3.0% cresol killed all bacilli within 120 seconds, while 0.1%, 0.2%, and 0.5% AEG all required 60 minutes to kill 99.9% or more of the bacilli; 2.0% glutaraldehyde required 10 minutes to kill all bacilli. CONCLUSION: The bactericidal activities of antiseptics for MDR-TB were similar to those for drug-sensitive M. tuberculosis strains. PVP-I would be a useful antiseptic against MDR-TB. The bactericidal activities of glutaraldehyde are effective against MDR-TB as an antiseptic for medical equipment.

Anti-Infective Agents, Local↗
PubMed2002

To use or not to use? The debate on the use of antiseptics in wound care.

The use of antiseptics for wound care has long been controversial. Antiseptics have a broad spectrum of activity that, in addition to making them effective against a broad range of microorganisms, makes them toxic to living human tissue. Consequently antiseptics gradually fell out of favour following the introduction of systemic antibiotics. In recent years, however, there has been renewed interest in antiseptics as a result of the evolution of antibiotic-resistant bacteria, and considerable funds are being invested in the development of modern antiseptic dressings. This article aims to discuss some of these issues and set them in a practical context so that readers recognize the complexities of decision-making where antiseptics are concerned. This in turn should enable them to make a better-informed choice for their patients or, where appropriate, seek expert advice.

Acute Disease↗
PubMed1991

[A study of resistance to antiseptics of methicillin resistant Staphylococcus aureus (MRSA) in gastroenterological surgery].

Highly methicillin-resistant Staphylococcus aureus (H-MRSA, MIC greater than 100 micrograms/ml) was prevalent from 1986 in our institution. The failure of povidone-iodine to reduce the prevalence of MRSA led us to choose chlorhexidine-ethanol solution as an antiseptic, and then the isolation frequency of H-MRSA decreased significantly in 1988. When H-MRSA began to increase again recently, we studied the resistance to antiseptics of MRSA in order to investigate the cause of this re-increase. Common antiseptics were tested against 45 strains of H-MRSA and 22 strains of methicillin sensitive S. aureus (MSSA, MIC less than 12.5 micrograms/ml). Dilute preparations (1:100) of povidone-iodine and chlorhexidine-ethanol solution were more effective on H-MRSA than the other antiseptics. Though there was no significant difference between H-MRSA and MSSA in their sensitivity to povidone-iodine, the killing of H-MRSA strains was more delayed than the killing of MSSA strains in chlorhexidine. Even after a 120-second exposure, 13.3% of H-MRSA strains were resistant to chlorhexidine (more than 1000 colonies were recovered). These highly chlorhexidine-resistant strains have been isolated since 1987 when we chose chlorhexidine-ethanol solution as the antiseptic in our institution. Therefore we suspect that the acquirement of resistance to antiseptics by H-MRSA caused the re-increase of this strain.

Anti-Infective Agents, Local↗
PubMed1989

[Antiseptic sensitivity of clinical strains of Pseudomonas aeruginosa].

MICs, the frequency of clinical and statistic resistance and the antiseptic activity index were studied in complex on out-of-hospital and hospital ecovars of P. aeruginosa. The forms resistant to a number of antiseptics, i.e. chloramine B, chlorhexidine, decamethoxine and dioxidine whose frequency eventually increased were shown to be widely distributed. The antiseptic sensitivity spectrum was more narrow and more heterogeneous than that of other bacteria, the heterogeneity level being dependent on the antiseptic type and bacterial ecovar. The activity of pervomur, phenol, resorcin and boric acid was higher against the clinical strains of P. aeruginosa while iodopyrin, sulfacetamide sodium and dioxidine were less active. The P. aeruginosa strains had natural resistance to cetylpyridinium chloride, rokkal, ethonium, sodium laurate and laurylsulfate and rivanol. It was recommended to assay antiseptic sensitivity of agents causing purulent inflammatory infections and to control circulation of antiseptic resistant variants of bacteria in hospitals.

Anti-Infective Agents, Local↗
PubMed2006

Preoperative bathing or showering with skin antiseptics to prevent surgical site infection.

BACKGROUND: Surgical site infections (SSIs) are wound infections that occur after invasive (surgical) procedures. Preoperative bathing or showering with an antiseptic skin wash product is a well-accepted procedure for reducing skin bacteria (microflora). It is less clear whether reducing skin microflora leads to a lower incidence of surgical site infection. OBJECTIVES: To review the evidence for preoperative bathing or showering with antiseptics for the prevention of hospital-acquired (nosocomial) surgical site infection. SEARCH STRATEGY: We searched the Cochrane Wounds Group Specialised Register (December 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2005), MEDLINE (January 1966 to December 2005) and reference lists of articles. SELECTION CRITERIA: Randomised controlled trials comparing any antiseptic preparation used for preoperative full-body bathing or showering with non-antiseptic preparations in patients undergoing surgery. DATA COLLECTION AND ANALYSIS: Two authors independently assessed studies for selection, trial quality and extracted data. Study authors were contacted for additional information. MAIN RESULTS: Six trials involving a total of 10,007 participants were included. Three of the included trials had three comparison groups. The antiseptic used in all trials was 4% chlorhexidine gluconate (Hibiscrub). Three trials involving 7691 participants compared chlorhexidine with a placebo. Bathing with chlorhexidine compared with a placebo did not result in a statistically significant reduction in SSIs; the relative risk of SSI (RR) was 0.91 (95% confidence interval (CI) 0.80 to 1.04). When only trials of high quality were included in this comparison, the RR of SSI was 0.95 (95%CI 0.82 to 0.10). Three trials of 1443 participants compared bar soap with chlorhexidine; when combined there was no difference in the risk of SSIs (RR 1.02, 95% CI 0.57 to 1.84). Two trials of 1092 patients compared bathing with chlorhexidine with no washing. No difference was found in the postoperative SSI rate between patients who washed with chlorhexidine and those who did not wash preoperatively (RR 0.70, 95% CI 0.19 to 2.58). AUTHORS' CONCLUSIONS: This review provides evidence of no benefit for preoperative showering or bathing with chlorhexidine over other wash products, to reduce surgical site infection. Efforts to reduce the incidence of nosocomial surgical site infection should focus on interventions where effect has been demonstrated.

Anti-Infective Agents, Local↗
PubMed2002

Topical antiseptics as an alternative in the treatment of acute vulvovaginal candidosis.

The aim of this prospective, multicenter, randomized, case-control study was to investigate the efficacy of a nonspecific mucosal antiseptic (octenidine dihydrochloride, phenoxyethanol) with proven antifungal effects, in patients with acute symptomatic vaginal candidosis, in comparison with a specific topical antifungal agent (clotrimazole), particularly in respect to non-Candida albicans yeasts. A total of 491 patients from 29 gynecological practices, who had new clinical vaginal mycosis, not treated with antifungal agents in the last 12 months, were included in the study. The diagnosis in each case was confirmed by microscopy or positive culture. The majority of the vaginal mycoses were infections with C. albicans (72%). In 28% of patients a non- Candida species (mainly C. glabrata) contributed to the infection. Except for vaginal discharge, the success of treatment was between 71% and 91% for both clinical and subjective parameters. The control preparation was significantly better than the treatment in the test group. Mycological cure rate on the basis of cultures was 78% in the test group and 87% in the control group. These results were also significantly different. The relatively high proportion of C. glabrata isolates in this study tended to be more successfully treated by the antiseptic (to 72%) than by the administration of clotrimazole (59%). Even though therapeutic success with clotrimazole was overall significantly better than with the test preparation, the success of treatment with the antiseptic used was within the range between 70% and 90% described for topical antifungal agents. Both the good efficacy of the topical antiseptic and the increased prevalence of non-Candida albicans species causing vaginal infections mean that the use of an antiseptic may be considered a suitable alternative therapeutic concept to an appropriate topical antifungal agent in the treatment of acute vaginal candidosis.

Acute Disease↗
PubMed2006

Are antiseptic-coated central venous catheters effective in a real-world setting?

BACKGROUND: Catheter-related bloodstream infections are common, costly, and morbid. Randomized controlled trials indicate that antiseptic-coated central venous catheters reduce infection rates. OBJECTIVE: To assess the clinical and economic effectiveness of antiseptic-coated catheters for critically ill patients in a real-world setting. METHODS: Central venous catheters coated with chlorhexidine/silver-sulfadiazene were introduced in all patients requiring central venous access in adult intensive care units at the University of Michigan Health System, a large, tertiary care teaching hospital. A pretest-posttest cohort design measured the primary outcome of catheter-related bloodstream infection rate, comparing the 2 years prior to the intervention with the 2 years following the intervention. We also evaluated cost-effectiveness and changes in vancomycin use. RESULTS: The intervention was associated with a 4% per month relative reduction in the incidence of catheter-related bloodstream infection, after controlling for the effects of time. Overall, a 35% relative risk reduction (P < .0003) in the catheter-related bloodstream infection rate occurred in the posttest phase. The use of antiseptic-coated catheters reduced costs more than $100,000 annually. Vancomycin use was less in units in which antiseptic catheters were used compared with wards in which these catheters were not used. CONCLUSION: Antiseptic-coated catheters appear to be clinically effective and economically efficient in a real-world setting.

Anti-Bacterial Agents↗
PubMed2004

Impact of antiseptics on radical metabolism, antioxidant status and genotoxic stress in blood cells: povidone-iodine versus octenidine dihydrochloride.

No sufficient data are available of the of antiseptics' influence on human blood cells. Effects of two antiseptics, povidone-iodine (PVD-I) versus octenidine dihydrochloride (OD), were tested on antioxidant status, radical formation, antioxidant defence enzymes and genotoxic stress in blood cells, in vitro. Human blood was taken by venipuncture, enriched with PVD-I or OD (0.0001-20% final concentration) and incubated at 37 degrees C between 30 and 120 min. alpha-Tocopherol was assessed in erythrocytes and granulocytes. Superoxide-dismutase (SOD) and glutathione (GSH) were determined in erythrocytes, the total anti-oxidative capacity (TAC) and malondialdehyde (MDA) in their ghosts. In granulocytes status of hydrogen peroxide (H(2)O(2)), superoxide anions and MDA was observed. Genotoxic stress was determined by counting sister chromatide exchanges (SCE) in lymphocytes after enrichment within 0.05-0.4% of antiseptics. Based on all biomarker tested, concentrations up to 0.05% incubated for 30 min did not affect cell metabolism. 1% and 10% PVD-I reduced the activity of SOD (-40%), GSH (-62%) and the content of alpha-tocopherol more than OD (p<0.05). No significant differences between the antiseptics were observed for TAC and MDA. H(2)O(2) and superoxide anions were significantly reduced after the 10% addition for both substances independent on the exposure. Without having changes in lipid oxidation, the reduction of antioxidative defence mechanisms must be due to the oxidation caused by the antiseptics, mainly PVD-I. An increased SCE rate was neither observed with PVD-I nor with OD within an enrichment with 0.05-0.4%. Higher concentrations (1% and more) could not be tested on SCE formation because they caused cell bursts. The results presented indicate that concentrations up to 0.05% incubated for 30 min are safe for exposing blood cells of healthy subjects.

Anti-Infective Agents, Local↗
PubMed1997

Topical iodine-containing antiseptics and subclinical hypothyroidism in preterm infants.

The influence of topical iodine-containing antiseptics on thyroid function test results of premature infants was determined in two separate studies. Thyroxine and thyrotropin levels were measured on blood-spotted filter paper. Samples were obtained from 128 premature infants on their tenth day of life; the infants were treated in two neonatal intensive care units. Both units used similar treatment protocols; however, one routinely used topical iodinated antiseptic agents (n = 73), whereas the other used chlorhexidine-containing antiseptics (n = 55). There was no difference in the mean T4 levels between the two groups. The mean thyrotropin levels were elevated in preterm babies exposed to iodine (15.4 vs 7.8 mIU/L, p < 0.01). Among the iodine-exposed infants, elevated thyrotropin levels (> 30 mIU/L) were found in 13.7% of infants, compared with none in the chlorhexidine-treated group (p < 0.01). We then studied an additional 46 premature infants who were treated in one neonatal intensive care unit. Iodine-containing solutions were used in 24 infants and chlorhexidine was used in 22 infants. T4 and thyrotropin levels were measured weekly during the first 28 days, one every 2 weeks until the age of 60 days, and at the age of 90 days. Among iodine-exposed infants, 20.8% had thyrotropin values > 30 mIU/L, whereas none of the infants in the chlorhexidine group had elevated thyrotropin values (p < 0.05). The elevated thyrotropin levels correlated positively with the area of disinfection. Elevated urine iodine levels were present reflecting an abnormally high iodine absorption. This study suggests that iodine absorption from topical iodine-containing antiseptics may cause disturbances in thyroid function test results in premature infants. We recommend that caution be exercised in the use of iodine-containing antiseptics in premature infants.

Anti-Infective Agents, Local↗