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Antiseptics

Antiseptics

Definition

An antiseptic is a substance that 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 that are used internally, such as the urinary tract antiseptics.


Purpose

Antiseptics are a diverse class of drugs that are applied to skin surfaces or mucous membranes for their anti-infective effects. This may be either bacteriocidal (kills bacteria) or bacteriostatic (stops the growth of bacteria). 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 that 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 as 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 that 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 abraded (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. Patients should ask a physician.


Precautions

Precautions vary with individual product and use.

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.

Most antiseptics have not been rated according to pregnancy category under the pregnancy risk factor system. Hexachlorophene is schedule C during pregnancy, and should not be used on newborns due to risk of systemic absorption with potential central nervous system (CNS) effects, including convulsions. Application of hexachlorophene to open wounds, mucous membranes, or areas of thin skin, such as the genitalia, should be avoided, since this may promote systemic absorption.

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.

McDonnell, Gerald and A. Denver Russell. "Antiseptics and Disinfectants: Activity, Action, and Resistance." Clinical Microbiology Reviews Vol. 12, No. 1 (January 1999): 147179. Also available at <http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=88911>. [cited June 30, 2003].

Waldman, Hilary. "New ways to treat wounds; Doctors abandon failed conventions that focus on caring for bruises at the surface for methods that reach the source." Los Angeles Times (May 26, 2003).

Weber J. et al. "Efficacy of selected hand hygiene agents used to remove Bacillus atrophaeus (a surrogate of Bacillus anthracis ) from contaminated hands." Journal of the American Medical Association (Mar 12, 2003).

other

United States Department of Energy. "Antiseptics and Disinfectants." Ask A Scientist: Molecular Biology Archive. December 04, 2002 [cited June 29, 2003]. <http://newton.dep.anl.gov/askasci/mole00/mole00361.htm>.


Samuel Uretsky, PharmD

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"Antiseptics." Gale Encyclopedia of Surgery: A Guide for Patients and Caregivers. . Encyclopedia.com. 22 Aug. 2017 <http://www.encyclopedia.com>.

"Antiseptics." Gale Encyclopedia of Surgery: A Guide for Patients and Caregivers. . Encyclopedia.com. (August 22, 2017). http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/antiseptics

"Antiseptics." Gale Encyclopedia of Surgery: A Guide for Patients and Caregivers. . Retrieved August 22, 2017 from Encyclopedia.com: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/antiseptics

Antiseptics

Antiseptics

Antiseptics are compounds that act to counteract sepsis, which is an illness caused by a bacterial infection of the blood. Antiseptics are able to counteract sepsis by preventing the growth of pathogenic (disease causing) microorganisms . An antiseptic may kill a microorganism, but it does not necessarily have to. The treated microbes may only be weakened. The weaker, slower growing microbes may then be more susceptible to the defense mechanisms of the host.

The terms antiseptic and disinfectant are used almost interchangeably nowadays. Yet they do have different meanings. An antiseptic is a chemical or technique that is used on people. A disinfectant is a chemical that is applied to an inanimate object or surface to get rid of microorganisms. An antiseptic generally does not have the same potency as a disinfectant. Otherwise, the chemical would harm the tissues it is in contact with. For this reason, an antiseptic should not be used to treat inanimate objects. Likewise, the generally more toxic disinfectant should not be used to treat skin or areas such as the mucous membranes of the nose.

While more is known of the molecular basis of antiseptic actions, the use of antimicrobial compounds is ancient. For example, the black eye make-up known as kohl, which was used by the ancient Arabs and Egyptians, is a mixture of copper and antimony. These compounds are antiseptic. Indeed, the modern cure for trachoma (blindness caused by infection of the eyes by the bacterium Chlamydia trachomatis ) is remarkably similar in composition to kohl.

There are a number of antiseptics and antiseptic procedures.

In a health care setting, powerful antiseptics are used to ensure that the skin is essentially sterile prior to an operation. Examples of such antiseptics include chlorhexidine and iodophors (iodine-containing compounds). Alcohol is an antiseptic, which is routinely used to swab the skin prior to an injection. Alcohol acts to coagulate the protein in bacteria . The irreversible change in the protein is lethal to the bacteria. In the example of the injection, alcohol swabbing of the injection site will kill the bacteria on the skin, so that living bacteria are not carried into the body upon insertion of the needle. Dilution of alcohol, so that a solution is 30% alcohol by volume, makes this antiseptic even more potent, as it allows the alcohol to permeate into the bacteria. Pure alcohol rapidly coagulates surface proteins, producing a coagulated crust around the bacteria.

Another antiseptic is carbolic acid. This is also known as phenol. The coal tar-based product was discovered in 1834. Originally phenol was poured down sewers to kill microorganisms. Over time, its use expanded. In 1863, the British surgeon Joseph Lister began using a spray of phenol to disinfect open wounds during surgery. Prior to his innovation, such surgery was only performed when all other avenues of treatment had failed, since the risk of death from infection was extremely high.

Still another antiseptic compound is pine oil. It is added to household disinfectants more because of its pleasant smell than its aseptic power nowadays. In fact, it inclusion actually weakens the bacteria-killing power of the household disinfectant.

Lister's method was supplanted by the adoption of extreme cleanliness in the operating room, such as the use of sterile masks, gloves and gowns, in order to keep the surgical area free of microorganisms. This approach is known as antiseptic surgery. As strange as it may seem now, surgeons in Lister's era often did not change or clean their operating garb between operations. A surgeon would often commence an operation wearing a gown covered with the blood and germs of many previous operations. Prior to the introduction of antisepsis in the operating room, the rate of death following surgery was almost 60%. After the introduction of antisepsis, the recorded death rate in England dropped to four per cent.

Hand washing has also become standard practice in the hospital and the home.

Another antiseptic technique is sterilization . The use of steam at higher than atmospheric pressure is an effective means of killing many types of bacteria, including those that form spores.

In the home, antiseptics are often evident as lotions or solutions that are applied to a cut or scrape to prevent infection. For these uses, it is necessary to clean the affected area of skin first to dislodge any dirt or other material that could reduce the effectiveness of the antiseptic. Antiseptics, particularly those used in the home, are designed for a short-term use to temporarily rid the skin of microbes. The skin, being in primary contact with the environment, will quickly become recolonized with microorganisms. Long-term use of antiseptics encourages the development of populations of microorganisms that are resistant to the antiseptic. Additionally, the skin can become irritated by the long exposure to the harsh chemical. Some people can even develop allergies to the antiseptic.

Another hazard of antiseptics that has only become apparent since the 1990s is the contamination of the environment. Antiseptic solutions that are disposed of in sinks and toilets can make their way to rivers and lakes. Contamination of the aquifer (the surface or underground reserve of water from which drinking water is obtained) has become a real possibility.

See also Antibiotics; Infection control

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"Antiseptics." World of Microbiology and Immunology. . Retrieved August 22, 2017 from Encyclopedia.com: http://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/antiseptics

Antiseptics

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.

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"Antiseptics." Gale Encyclopedia of Medicine, 3rd ed.. . Encyclopedia.com. 22 Aug. 2017 <http://www.encyclopedia.com>.

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"Antiseptics." Gale Encyclopedia of Medicine, 3rd ed.. . Retrieved August 22, 2017 from Encyclopedia.com: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/antiseptics-0

Antiseptics

Antiseptics

Antisepsis (from the Greek, anti, meaning "against," and sepsis, meaning "decay") is the destruction or control of the growth of microorganisms on living tissue. Antiseptics are the substances that carry out antisepsis. They are applied externally to prevent bacterial growth, to treat skin infections, and to disinfect wounds.

Early uses of antiseptics

From the earliest times, physicians and healers were aware that certain substances appeared to stop infection and prevent spoilage. Egyptians used resins (natural organic substances), naphtha (flammable liquid hydrocarbon mixtures), and liquid pitch (tar) to decrease decay when preparing their dead for burial. The ancient Greeks and Romans recognized the antiseptic properties of wine, oil, and vinegar. Balsam was used in Europe from the Middle Ages (4001450) times through the 1800s. Chloride of mercury was introduced as an antiseptic in 1766, and iodine became popular as an antiseptic treatment for wounds after its discovery in 1811.

Infection

None of these antiseptics could prevent the almost inevitable infection of wounds, particularly following surgery. Amputations, common in the 1800s, resulted in a high death rate due to infection. The introduction of anesthesia in 1846 added to the problem; it permitted longer and more complex operations, greatly increasing the likelihood of infection following surgery.

Another deadly form of infection was so-called childbed fever, a bacterial infection of the uterus that struck women who had just given birth. Epidemics of childbed fever raced through hospital maternity wards, killing many new mothers. With no knowledge of the existence of bacteria, physicians had no concern for cleanliness. They wore street clothes or filthy operating gowns, used unclean instruments, and often failed to wash their hands properly before examining or operating on patients.

Advances in antisepsis

Some of the early advances in antisepsis came about because of attempts to understand and stop childbed fever. Toward the end of the eighteenth century, some doctors began to realize that lack of cleanliness might be related to the spread of infection. When doctors began washing their clothes and hands before examining patients, death rates from infection began to drop dramatically.

Words to Know

Antiseptic: A substance that prevents or stops the growth of microorganisms.

Carbolic acid: An acidic compound that, when diluted with water, is used as an antiseptic and disinfectant.

Childbed fever: A bacterial infection occurring in women following childbirth, causing fever and in some cases blood poisoning and possible death.

Infection: Invasion and multiplication of microorganisms in body tissues.

Sterilization: The process of making a substance free from microorganisms.

French chemist Louis Pasteur (18221895) helped to shed light on the source of infection by proving the existence of airborne microorganisms in the 1850s. English surgeon Joseph Lister (18271912) applied this new knowledge of bacteria to develop a successful system of antiseptic surgery. Concluding that microorganisms in the air caused the infection of wounds, Lister developed an antiseptic system using carbolic acid. Wounds and surrounding areas were sprayed with the acid to destroy infectious organisms. Multiple layers of dressing were then applied to wounds to protect them from new invasion by bacteria. Lister's method of antisepsis proved to be effective and was eventually adopted by physicians worldwide.

Improvements on Lister's techniques soon developed. The carbolic spray was abandoned in the 1880s in favor of cleanliness, sterilization, and topical antiseptics (antiseptics applied directly to a surface). A final obstacle to surgical antisepsisgerms on the human handswas overcome by the introduction of rubber gloves. Today, sterile gloves are a requirement for surgical procedures.

Modern methods of preventing infection are very different from the techniques pioneered by Lister and others. Antibiotics, penicillin, and sulfa drugs fight infection inside the body, and aseptic (free from harmful microorganisms) methods such as sterilization prevent bacteria from existing in a given area. However, external antiseptics continue to be important.

Some commonly used antiseptics are hydrogen peroxide, alcohol, boric acid, iodine, formaldehyde, and hexachlorophene. Heat is also an extremely effective antiseptic and, at appropriate temperatures, can be used to disinfect many materials.

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antiseptic

antiseptic, agent that kills or inhibits the growth of microorganisms on the external surfaces of the body. Antiseptics should generally be distinguished from drugs such as antibiotics that destroy microorganisms internally, and from disinfectants, which destroy microorganisms found on nonliving objects. Germicides include only those antiseptics that kill microorganisms. Some common antiseptics are alcohol, iodine, hydrogen peroxide, and boric acid. There is great variation in the ability of antiseptics to destroy microorganisms and in their effect on living tissue. For example, mercuric chloride is a powerful antiseptic, but it irritates delicate tissue. In contrast, silver nitrate kills fewer germs but can be used on the delicate tissues of the eyes and throat. There is also a great difference in the time required for different antiseptics to work. Iodine, one of the fastest-working antiseptics, kills bacteria within 30 sec. Other antiseptics have slower, more residual action. Since so much variability exists, systems have been devised for measuring the action of an antiseptic against certain standards. The bacteriostatic action of an antiseptic compared to that of phenol (under the same conditions and against the same microorganism) is known as its phenol coefficient. Joseph Lister was the first to employ the antiseptic phenol, or carbolic acid, in surgery, following the discovery by Louis Pasteur that microorganisms are the cause of infections. Modern surgical techniques for avoiding infection are founded on asepsis, the absence of pathogenic organisms. Sterilization is the chief means of achieving asepsis.

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antiseptic

an·ti·sep·tic / ˌantiˈseptik/ • adj. of, relating to, or denoting substances that prevent the growth of disease-causing microorganisms. ∎  (of medical techniques) based on the use of such substances. ∎ fig. scrupulously clean or pure, esp. so as to be bland or characterless. • n. an antiseptic compound or preparation. DERIVATIVES: an·ti·sep·ti·cal·ly / -ik(ə)lē/ adv.

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antiseptic

antiseptic Chemicals that destroy or stop the growth of many microorganisms. Antiseptics are weak germicides that can be used on the skin. The English surgeon Joseph Lister pioneered the use of antiseptics in 1867. Those commonly used include alcohol, iodine, and hydrogen peroxide. See also antibiotic

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antiseptic

antiseptic Any substance that kills or inhibits the growth of disease-causing microorganisms but is essentially nontoxic to cells of the body. Common antiseptics include hydrogen peroxide, the detergent cetrimide, and ethanol. They are used to treat minor wounds. Compare disinfectant.

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antiseptic

antiseptic (anti-sep-tik) n. a chemical, such as chlorhexidine or cetrimide, that destroys or inhibits the growth of disease-causing bacteria and other microorganisms. Antiseptics are used externally to cleanse wounds and internally to treat infections of the intestine and bladder.

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antiseptic

antiseptic XVIII. — modL. antisēpticus, f. ANTI- + Gr. sēptikós SEPTIC.

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