antiseptics


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Antiseptics

 

Definition

An antiseptic is a substance which inhibits the growth and development of microorganisms. For practical purposes, antiseptics are routinely thought of as topical agents, for application to skin, mucous membranes, and inanimate objects, although a formal definition includes agents which are used internally, such as the urinary tract antiseptics.

Purpose

Antiseptics are a diverse class of drugs which are applied to skin surfaces or mucous membranes for their anti-infective effects. This may be either bacteriocidal or bacteriostatic. Their uses include cleansing of skin and wound surfaces after injury, preparation of skin surfaces prior to injections or surgical procedures, and routine disinfection of the oral cavity as part of a program of oral hygiene. Antiseptics are also used for disinfection of inanimate objects, including instruments and furniture surfaces.
Commonly used antiseptics for skin cleaning include benzalkonium chloride, chlorhexidine, hexachlorophine, iodine compounds, mercury compounds, alcohol and hydrogen peroxide. Other agents which have been used for this purpose, but have largely been supplanted by more effective or safer agents, include boric acid and volatile oils such as methyl salicylate (oil of wintergreen.)
Chlorhexidine shows a high margin of safety when applied to mucous membranes, and has been used in oral rinses and preoperative total body washes.
Benzalkonium chloride and hexachlorophine are used primarily as hand scrubs or face washes. Benzalkonium may also find application is a disinfecting agent for instruments, and in low concentration as a preservative for drugs including ophthalmic solutions. Benzalkonium chloride is inactivated by organic compounds, including soap, and must not be applied to areas which have not been fully rinsed.
Iodine compounds include tincture of iodine and povidone iodine compounds. Iodine compounds have the broadest spectrum of all topical anti-infectives, with action against bacteria, fungi, viruses, spores, protozoa, and yeasts. Iodine tincture is highly effective, but its alcoholic component is drying and extremely irritating when applied to abraided (scraped or rubbed) skin. Povidone iodine, an organic compound, is less irritating and less toxic, but not as effective. Povidone iodine has been used for hand scrubs and disinfection of surgical sites. Aqueous solutions of iodine have also been used as antiseptic agents, but are less effective than alcoholic solutions and less convenient to use that the povidone iodine compounds.
Hydrogen peroxide acts through the liberation of oxygen gas. Although the antibacterial activity of hydrogen peroxide is relatively weak, the liberation of oxygen bubbles produces an effervescent action, which may be useful for wound cleansing through removal of tissue debris. The activity of hydrogen peroxide may be reduced by the presence of blood and pus. The appropriate concentration of hydrogen peroxide for antiseptic use is 3%, although higher concentrations are available.
Thimerosol (Mersol) is a mercury compound with activity against bacteria and yeasts. Prolonged use may result in mercury toxicity.

Recommended dosage

Dosage varies with product and intended use. Consult individualized references.

Precautions

Precautions vary with individual product and use. Consult individualized references.
Hypersensitivity reactions should be considered with organic compounds such as chlorhexidine, benzalkonium and hexachlorophine.
Skin dryness and irritation should be considered with all products, but particularly with those containing alcohol.
Systemic toxicity may result from ingestion of iodine containing compounds or mercury compounds.
Chlorhexidine should not be instilled into the ear. There is one anecdotal report of deafness following use of chlorhexidine in a patient with a perforated eardrum. Safety in pregnancy and breastfeeding have not been reported, however there is one anecdotal report of an infant developing slowed heartbeat apparently related to maternal use of chlorhexidine.
Iodine compounds should be used sparingly during pregnancy and lactation due to risk of infant absorption of iodine with alterations in thyroid function.

Interactions

Antiseptics are not known to interact with any other medicines. However, they should not be used together with any other topical cream, solution, or ointment.

Resources

Periodicals

Farley, Dixie. "Help for Cuts, Scrapes and Burns." FDA Consumer May 1996: 12.

Key terms

Antibiotic — A medicine used to treat infections.
Bacteria — Tiny, one-celled forms of life that cause many diseases and infections.
Mucous membrane — The moist lining of a body cavity or structure, such as the mouth or nose.
Residue — Traces that remain after most of the rest of the material is gone.

antiseptics

chemical substances that destroy or inhibit the growth of micro-organisms. Some can be applied to living tissues, e.g. chlorhexidine used for skin preparation before invasive procedures and for hand decontamination.
References in periodicals archive ?
Based on new scientific information and concerns expressed by outside scientific and medical experts on an FDA advisory committee, the agency is requesting additional scientific data to demonstrate that health care antiseptics in the over-the-counter drug monograph are generally recognized as safe and effective (GRASE) for their intended use to reduce bacteria that potentially can cause disease.
The broad spectrum antiseptic is available as hand wash, mouth wash and a whole range of products that can stop the spread of the infection through any body fluids.
While some manufacturers stated altering their manufacturing processes to include sterilization would require considerable time and expense, there are currently topical skin antiseptics available that are sterile.
A second study found the antiseptic did a better job of preventing infections than the reddish-brown iodine solution that's been used for decades to swab the skin before an operation.
Rutka: The use of topical antiseptics and disinfectants is less likely to lead to bacterial resistance.
It can be used in place of soap and water to clean minor scrapes and cuts, eliminating the need for antiseptic ointment.
Aborigines used tea tree oil for hundreds of years before European settlers and scientists discovered its antiseptic uses in the 1920s, after distilling it from the prunings of small, narrow leaves.
Grocery is becoming an increasingly important arena for antiseptics.
But it's important to understand that wound healing and skin care is constantly evolving, as are the concerns of practitioners about infections, antiseptics, antibacterials and so on.
Solarcaine, made by Schering-Plough HealthCare Products, also falls under Towne-Oller's first aid antiseptics umbrella.
The concept of applying an antiseptic by passing a current through a metallized fabric is appealing, the researchers say, because the dose can be regulated by controlling the current.