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PubMed1993

A study of the efficacy of antimicrobial detergents for hand washing: using the full-hand touch plates method.

We studied the effects of four kinds of antimicrobial detergents, 4% chlorhexidine gluconate (CHG), chlorbenzarconium (CBC), 10% povidone-iodine (PVI), 0.3% triclosan (TRI), and one non-medicated detergent (NMD) using the full-hand touch plates method. Before and after 3 minutes of hand scrubbing with a brush, bacterial colonies on the hand surface and subungual bacteria were counted. CHG, CBC, and PVI were excellent antimicrobial detergents against hand surface bacteria, but most of the subungual bacteria remained. The subungual space was the most difficult region from which to eradicate bacteria. TRI was much less effective than hand soap against hand surface bacteria.

Adult↗
PubMed1994

An evaluation of the residual activity of antiseptic handrub lotions: an 'in use' setting study.

An evaluation of the residual activity of quick-drying agents (alcoholic solutions) used for hygienic hand disinfection is described. We looked for residual efficacy following hand disinfection with soap and water alone or followed by one of two alcoholic handrub lotions supplied from an automatic hand washing machine. The bacterial counts on the hands obtained before and within 2 successive hours after disinfection showed that alcoholic chlorhexidine was the most effective for 10 minutes after contamination of the hands. WELPAS (alcoholic chlorbenzarconium) followed this in its immediate effect and was better than soap and water alone. There were no significant differences after 30' or 120' between the three disinfecting methods.

Adult↗
PubMed1988

The contribution of histamine release to bronchoconstriction provoked by inhaled benzalkonium chloride in asthma.

1. To investigate the possibility that benzalkonium chloride-induced bronchoconstriction results from the endogenous release of histamine, we examined the effect of the selective histamine antagonists terfenadine and astemizole, on the airways response to inhaled benzalkonium chloride and histamine in 12 asthmatic subjects. 2. Double-blind concentration- and time-course studies were undertaken, 3 h after treatment with terfenadine or matched placebo. 3. Benzalkonium chloride and histamine caused concentration-related falls in FEV1 in all subjects with benzalkonium chloride being 7.4 times less potent as a bronchoconstrictor agonist than histamine. Terfenadine displaced to the right the benzalkonium chloride and histamine concentration-response curves by 3.7 and 111 fold respectively. Terfenadine attenuated the initial (5 min) bronchoconstrictor response to benzalkonium chloride by 40%. However, over the whole 45 min period, the response was reduced by only 13% compared with 86% inhibition of the response to histamine. 4. In an open study, eight of the 12 subjects undertook a time course study with inhaled benzalkonium chloride after pretreatment with the chemically unrelated histamine antagonist astemizole. Astemizole inhibited benzalkonium chloride-induced bronchoconstriction to an almost identical degree as that achieved with terfenadine. 5. We conclude that the initial bronchoconstrictor effect of benzalkonium chloride is due, in part, to histamine release. However, the majority of the adverse effect relates to other, as yet unrecognised effects of this bacteriocidal substance.

Adult↗
PubMed1988

The influence of ipratropium bromide and sodium cromoglycate on benzalkonium chloride-induced bronchoconstriction in asthma.

1. Benzalkonium chloride, an antibacterial preservative that is added to nebuliser solutions, has been shown to cause bronchoconstriction when inhaled by asthmatic subjects. 2. To investigate the potential role of reflex and mast cell-dependent mechanisms in the pathogenesis of bronchoconstriction produced by benzalkonium chloride we examined the effects of ipratropium bromide and sodium cromoglycate on this response in both concentration-response and time-course studies in nine asthmatic subjects. 3. Pretreatment with inhaled ipratropium bromide (1 mg) and sodium cromoglycate (40 mg) displaced the benzalkonium chloride concentration-response curves to the right by a mean 2.2 fold and 3.1 fold respectively. 4. Ipratropium bromide and sodium cromoglycate markedly attenuated the airway response to benzalkonium chloride throughout the 45 min time course period, inhibiting the overall response by 56% and 78% respectively. 5. We conclude that benzalkonium chloride provokes bronchoconstriction in asthmatic subjects through a combination of mast cell activation and stimulation of peripheral and central neural pathways.

Adult↗
PubMed1975

One hundred twin pairs patch tested with primary irritants.

The cutaneous sensitivity to benzalkonium chloride, sodium lauryl sulphate and potash soap was determined in 54 monozygotic and 46 dizygotic twin pairs. Comparing the intra-pair reaction strength a higher degree of concordance was found among monozygotic than among dizygotic twins, and even more so when monozygotic twins were compared with matched controls.

Adolescent↗
PubMed1976

An assessment of methods of treating viral warts by comparative treatment trials based on a standard design.

A series of eleven comparative wart treatment trials undertaken between 1969 and 1975 and involving 1802 patients is described. A method of coding provided groups of patients matched for age, type, number and duration of warts, within which treatments could be randomized. The variation in response to treatment was shown to be influenced significantly by these factors and the level of cure to depend on the proportions of the various response groups within the population under consideration. These proportions were found to vary geographically and at different periods. In all the trials the results were assessed at 12 weeks. In the treatment of hand warts, the percentage cure of patients treated with liquid nitrogen fell significantly from 75 to 40% when the interval between freezings was increased from 3 to 4 weeks. The average number of freezings required for a cure was 3-1 amongst all patients cured by 6 or less freezings at intervals of 2 or 3 weeks. In a two-centre trial there was no significant difference between the percentage cure of patients with hand warts treated with liquid nitrogen (69%) and of those applying a paint containing salicylic and lactic acids (SAL) (67%). Patients receiving both treatments concurrently did better (78%) but the difference was not found to be statistically significant. In the treatment of simple plantar warts the percentage cure for the SAL paint (84%) was found to compare favourably with that for a podophyllin treatment (81%). Only one of the patients cured by the paint in that trial was found to have had a recurrence after 6 months. The paint was found to be satisfactory for use under general practice conditions. Additions to the formula did not alter its effectiveness. In the treatment of mosaic plantar warts the overall percentage cure for the SAL paint in a series of comparative trials (1969-75) was 45%. In these trials it was compared directly with one or more other preparations. No differences were found between its efficacy and that of 10% buffered gluteraldehyde (47%), 40% benzalkonium chloride dibromide (Callusolve 40) (30%) and 5% 5-fluorouracil in dimethyl sulphoxide (53%). Only 25% of thirty-six patients treated with 5% idoxuridine in dimethylsulphoxide were cured. Throughout the trials approximately 30% of patients with hand warts, 20% of those with simple plantar warts and 50% of those with mosaic plantar warts were found to be resistant to treatment. The adoption of treatment with SAL paint for hand warts and simple plantar warts by the general practitioners in the Edinburgh area has proved satisfactory. Only resistant cases are now referred to hospital and these can be treated within a few weeks instead of 4-5 months as was the case in 1969.

Benzalkonium Compounds↗
PubMed1984

Levels of arachidonic acid and its metabolites in the skin in human allergic and irritant contact dermatitis.

Increased concentrations of arachidonic acid and prostaglandin E2, but not 12-hydroxy-eicosatetraenoic acid, were found in the skin in human contact dermatitis due to nickel and chromate allergens. Significant levels of neutrophil chemokinetic activity, with similar properties to leukotriene B4, were found in a high proportion of exudates from inflamed skin treated with allergen but not in exudates from untreated skin. Neither arachidonic acid nor its metabolites were increased in primary irritant dermatitis due to benzylalkonium chloride.

12-Hydroxy-5,8,10,14-eicosatetraenoic Acid↗
PubMed1986

Immunopathological and ultrastructural findings in human allergic and irritant contact dermatitis.

The histopathological features of allergic contact dermatitis were compared with those of irritant contact dermatitis in a group of 17 subjects. Each patient received simultaneous patch tests of a known allergen and a standardized irritant (benzalkonium chloride). The cellular changes occurring between 3 h and 7 days after patch test application were studied by light and electron microscopy and immunocytochemistry. No differences were observed between the induced allergic contact dermatitis (ACD) and the irritant contact dermatitis (ICD), either in the responding cell types or the sequence of cellular events. Both reactions showed a predominantly T lymphocyte infiltrate with no polymorphonuclear leukocyte involvement. Apposition of Langerhans cells to lymphocytes in the epidermis was seen in both types of response. Considerable variability in the intensity of reaction to irritant and allergen occurred within individuals. There was no statistically significant difference between the intensity of the reactions to the irritant and the allergen.

Adult↗
PubMed1994

A comparative study of the cytotoxicity of skin irritants on cultured human oral and skin keratinocytes.

The cytotoxicity of irritants on human oral and skin keratinocyte culture models was compared. Keratinocytes were exposed to sodium lauryl sulphate and benzalkonium chloride at concentrations of 10(-4)-10(-7) M for 24 h. Cytotoxicity was evaluated by changes in mitochondrial metabolic activity (MTT assay) and plasma membrane integrity (LDH leakage). Our results showed that oral and skin keratinocytes are equally sensitive to the irritants tested. There were marked similarities in susceptibility between each cell type cultured from six individuals. The immunohistochemical staining pattern of both cell types resembled that of the basal cell. These observations suggest that the skin keratinocyte culture model may be useful in evaluating the cytotoxicity of agents which are irritants on either the skin or oral mucosa.

Adolescent↗
PubMed1988

Effect of chemical ablation of myenteric neurones on intestinal cell proliferation.

The duodenum or descending colon of male Wistar rats (average weight 60 g) was treated by a serosal application of a 0.2% solution of benzalkonium chloride (BAC) for 30 min. Control animals were treated with 0.9% (physiological) saline. The rats were allocated to four groups: Group DC (N = 8) in which the duodenum was treated with physiological saline; Group DB (N = 8) in which the duodenum was treated with BAC; Group CC (N = 7) in which the descending colon was treated with physiological saline and Group CB (N = 7) in which the descending colon was treated with BAC. After treatment, the animals were followed up for 5 months. At the end of the experiment, the animals were injected intraperitoneally with vincristine sulphate before sacrifice. Three segments were removed from the duodenum and descending colon for neuronal counting, catecholamine and serotonin measurements and morphokinetic studies of the epithelium. The following results were obtained: (1) there was a significant reduction in neurone number in the myenteric plexus of segments treated with BAC; (2) in the denervated intestinal segments, catecholamine levels were unchanged whereas serotonin levels were increased; (3) epithelial hyperplasia was observed in the denervated duodenum and descending colon; and (4) crypt cell production rate in the duodenum was similar in groups DC and DB but was significantly increased in the descending colon in group CB as compared with controls (CC). The present findings indicate that selective myenteric neuronal denervation caused by benzalkonium chloride plays a causative role in the hyperplasia and crypt cell production rate of the intestinal epithelium (duodenum and descending colon). These changes are probably induced by functional imbalance by the surviving neuronal elements in the gut, implicating neurotransmitters such as acetylcholine, noradrenaline, serotonin, somatostatin and vasoactive intestinal peptide.

Animals↗
PubMed1991

The chronological relationship between the thickening of smooth muscle, epithelial cell proliferation and myenteric neural denervation in the rat jejunum.

The jejunum of rats was treated by serosal application of a 0.2% solution of benzalkonium chloride (BAC) for 30 min. Control animals were treated with saline (0.9% NaC1). The animals were allocated to eight groups of 10 rats each and sacrificed 15, 30, 45, 60 days after BAC treatment. Segments were removed from the jejunum for neuronal counting, measurement of the smooth muscle area and morphokinetic study of the epithelium. There was a significant reduction in neuron number in the myenteric plexus 30 days after BAC treatment, thickening of smooth muscle 15-60 days after BAC treatment, but no change in epithelial cell proliferation in the jejunum at either time.

Animals↗
PubMed1995

The lack of effect of benzalkonium chloride on the cilia of the nasal mucosa in patients with perennial allergic rhinitis: a combined functional, light, scanning and transmission electron microscopy study.

BACKGROUND: Controversy still exists about the effect of 0.02% benzalkonium chloride (BKC), a preservative in many nasal sprays, on human nasal epithelium in vivo. OBJECTIVE: To determine the safety of BKC by assessing its effect on the function and morphology of cilia of human nasal epithelium. METHODS: A single-centre, double-blind nasal biopsy study in 22 patients with perennial allergic rhinitis, receiving fluticasone propionate aqueous nasal spray (FPANS) containing BKC, BKC plus placebo or placebo alone for 6 weeks. Before, at two weekly intervals during treatment and 2 weeks after treatment ceased an indigocarmine saccharine transport time (ICST) was performed. RESULTS: ICST results did not significantly vary between the groups. There was no statistical relationship between the number of ciliated cells present and the treatment the patients received. Scanning and transmission electron microscopy examination showed no effects of BKC. CONCLUSION: Despite reports of its ciliostatic effects in vitro, BKC did not have such an effect when it was applied for 6 weeks (with/without fluticasone propionate) to the nasal mucosa of perennial allergic rhinitis patients in vivo.

Adolescent↗
PubMed1995

Benzalkonium chloride in a decongestant nasal spray aggravates rhinitis medicamentosa in healthy volunteers.

A randomized double-blind parallel study with 20 healthy volunteers was performed to research the effect of a preservative in a decongestant nasal spray on the development of rhinitis medicamentosa. Ten subjects received oxymetazoline nasal spray with benzalkonium chloride and the others used oxymetazoline nasal spray without the preservative three times daily for 30 days. Before starting the course of treatment and after its conclusion, recordings of the mucosal surface positions were made with rhinostereometry followed by histamine challenge tests. Symptoms of nasal stuffiness were estimated on visual analogue scales (0-100) in the morning and the evening just before using the nasal spray. After 30 days, rebound swelling and nasal stuffiness were found in both groups. In the group receiving oxymetazoline nasal spray with benzalkonium chloride the mean rebound swelling was 1.1 mm and the estimated mean evening symptom score for nasal stuffiness was 43. In the group without benzalkonium chloride the corresponding variables were significantly less marked, with a mean rebound swelling of 0.5 mm (P < 0.05) and a mean evening symptom score of 25 (P < 0.05). The increase in histamine sensitivity in both groups was interpreted as a sign of nasal hyperreactivity. A new type of nasal spray bottle was used that has been shown to prevent bacterial contamination. In conclusion, the long-term use of benzalkonium chloride in oxymetazoline nasal spray accentuates the severity of rhinitis medicamentosa in healthy volunteers.

Administration, Intranasal↗
PubMed1995

Benzalkonium chloride in nasal decongestive sprays has a long-lasting adverse effect on the nasal mucosa of healthy volunteers.

Twenty healthy volunteers participated in the present study on the long-term effects of a nasal decongestive spray composed of either a combination of oxymetazoline nasal spray and benzalkonium chloride or of oxymetazoline nasal spray alone. Three months before the present study the participants had undergone treatment with nasal decongestants for 4 weeks. Ten of the subjects had been treated with oxymetazoline nasal spray without benzalkonium chloride and 10 of them had been treated with oxymetazoline nasal spray with benzalkonium chloride. In a double-blind study the subjects who had been treated with oxymetazoline nasal spray and benzalkonium chloride were again treated with the same combination of substances as before, and the subjects who had been treated with oxymetazoline nasal spray alone were also treated again with oxymetazoline nasal spray alone, but on this occasion only for 10 days. Three variables were studied before and after the 10 days of treatment, i.e. nasal mucosa congestion, nasal reactivity and symptom scores. It was found that only the subjects who were treated with the combination of oxymetazoline nasal spray and benzalkonium chloride had increased nasal stuffiness, estimated by symptom scores and measurements of nasal mucosa swelling after 10 days of treatment. It is concluded that a nasal decongestant spray composed of a combination of vasoactive substance and benzalkonium chloride has a long-term adverse effect on the nasal mucosa.

Administration, Intranasal↗
PubMed2004

Immediate effect of benzalkonium chloride in decongestant nasal spray on the human nasal mucosal temperature.

Benzalkonium chloride is a preservative commonly used in nasal decongestant sprays. It has been suggested that benzalkonium chloride may be harmful to the nasal mucosa. Decongestion with the vasoconstrictor xylometazoline containing benzalkonium chloride has been shown to cause a significant reduction of the nasal mucosal temperature. The purpose of the present study was to determine the short-term influence of xylometazoline nasal spray with and without benzalkonium chloride on the nasal mucosal temperature. Healthy volunteers (30) were included in the study. Fifteen volunteers received xylometazoline nasal spray (1.0 mg/mL) containing benzalkonium chloride (0.1 mg/mL) and 15 age-matched subjects, received xylometazoline nasal spray without benzalkonium chloride. Using a miniaturized thermocouple the septal mucosal temperature was continuously measured at defined intranasal detection sites before and after application of the nasal spray. The mucosal temperature values did not significantly differ between the group receiving xylometazoline containing benzalkonium chloride and the group receiving xylometazoline spray without benzalkonium chloride before and after decongestion (P > 0.05). In both study groups septal mucosal temperatures significantly decreased after decongestion (P < 0.05) because of a reduction of the nasal mucosal blood flow following vasoconstriction. This study indicates that benzalkonium chloride itself does not seem to influence nasal blood flow and nasal mucosal temperature in topical nasal decongestants.

Administration, Inhalation↗