Antiseptics & Disinfectants

ANTISEPTICS & DISINFECTANTS
Sterlization
• Freeing of an article, surface or medium by
removing or killing all micro-organisms
including vegetative form of
bacteria, spores, viruses, fungii
Disinfection
• Destruction or inhibition of growth of all
pathogenic organisms (bacteria, viruses,
fungii) on non living surfaces
• If spores are also killed process is Sterlization
Antiseptics
• These are chemical substances
which inhibit the growth or kill micro-
organisms on living surfaces such as skin &
mucous membrane.
Properties of good antiseptic/
disinfectant
1. Cidal
2. Non staining & good odour
3. Active against all pathogens
4. Active in presence of pus, blood & exudates
5. Rapid acting
6. Non irritating to tissues / non corrosive
7. Non absorbable
8. Non sensitizing/
Mechanisms of action of antiseptic
and disinfectants
• Oxidation of bacterial protoplasm
– Potassium permagnate, H202, Halogens
• Co-agulation (denaturation) of bacterial
proteins & disrupt cell membrane
– Phenols, chlorhexidine, alcohols, aldehydes
• Detergent like action ↑ permeability of
bacterial cell membrane
– Cetrimide, soaps
Classification
• Phenol derivatives: • Alcohols:
– phenol, cresol, hexachlorophene, – Ethanol, isopropanol
chlorohexylenol (dettol) • Aldehyde:
• Oxidizing agents: – Formaldehyde
– Hydrogen peroxide. • Acids:
• Halogens: – Acetic acid, boric acid
– Iodine, chlorine, chlorophores. • Metallic salt:
• Biguanides: – Mercuric compounds , silver
– Chlorhexidine. & zinc salts
• Dyes:
• Quaternary ammonium:
– Gentian violet, acriflavine
– Cetrimide.
Phenol
• Earliest used, reference standard
• Protoplasmic poison,
– injures tissues & cells at high conc causes skin
burn
• MOA:
– denaturating bacterial protiens.
• USES :
– To disinfect urine, faeces, pus, burns.
• Extremely irritating, corrosive
CRESOL (Lysol)
• Methyl Derivative of phenol, less damaging
to tissues than phenol.
• 3-10 times more active
• used for disinfection of utensils, excreta &
for washing hands.
Chloroxylenol (Dettol)
• Phenol derivative
• Does not co-agulate proteins,
• Non corrosive,Non irritating to skin
• Commercial 4.8 % solution used for surgical
antisepsis
• Skin cream and soap: 0.8%
• Mouth wash 1%
Hexachlorophene
• Commonly incorporated in soap
• Effectively only against Gm+ve
• Slow but persistant action
• >2% preparations banned
Oxidizing agents
• Potassium permagnate:
– Purple crystals, highly water soluble, liberates
oxygen which oxidizes bacterial protoplasm.
– Used for gargling, irrigating wounds, urethra
(condy`s lotion diluted solution of 1:4000 to
1:10,000 )
– High conc cause burns
– It is also used to disinfect water in ponds.
– Stomach wash in alkaloidal poisoning
Oxidizing agents
Hydrogen Peroxide
– liberates nascent oxygen which oxidizes necrotic
matter & bacteria.
– Helps in loosening & removing slough, ear wax
etc.
Benzoyl Peroxide
– Widely used drug for acne.
– liberates O2 in presence of water which kills
bacteria, specially anaerobes
Halogens
• Iodine,
• Iodophores,
• Chlorine,
• Chlorophores
Iodine
• Rapidly acting broad spectrum
(bacteria, fungi,virus)
• Acts by iodinating and oxidizing microbial
protoplasm.
• Used for cuts, degerming skin beforesurgery.
• Adverse effect: cause burns & blisters
Iodophores
• Known as povidine iodine.
• Non toxic, non staining prolonged action.
• Used on
boils, furunculosis, burns, ulcers, tinea, surgica
l srub, disinfecting surgical instruments, non
specific vaginitis.
Chlorine
• potent germicide. Kills pathogens in 30 sec.
used to disinfect urban water supplies.
• 0.1 to 0.25 ppm
Cholorophores
(1) Chlorinated lime (bleaching powder)
– obtained by action of chlorine on lime.
– used to disinfect drinking water
(2) Sodium hypochlorite
– Powerful disinfectant used in dairies for milk
cans.
– Too Irritant to be used as antiseptic.
– Root canal therapy in dentisry
Biguanides
Chlorhexidine: (Savlon)
– Acts by disrupting bacterial cell membrane &
denaturation of bacterial proteins
– Non irritant ,more active against gram +ve
bacteria.
– Used in for surgical scrub, neonatal bath, mouth
wash & general skin antiseptic.
– Most widely used antiseptic in dentisry 0.12-0.2%
oral rinse or 0.5 -1 % tooth paste
Quarternary ammonium antiseptics
cetrimide
• Detergents: Cidal to bacteria, fungi & viruses.

• Act by altering permeability of cell membrane
• Efficiently remove dirt and grease
• Widely used as antiseptics & disinfectants for
surgical instruments, gloves etc
• Combined with chlorhexidine (savlon)
Soaps
• Anionic detergents
• Weak antiseptics with cleansing action
• Washing with soap and warm water one of
the most effective methods of preventing
disease transmission
• Affect only Gm+ bacteria
Alcohols
• Ethanol
– Antiseptic, cleansing agent at 40-90% conc.
– Act by precipating bacterial proteins
– Irritant, should not be applied on mucous
membrane, ulcers, open wounds.
Aldehydes (Formaldehyde)
• Used for fumigation.
• 37 % aqueous solution called as formalin.
• Protoplasmic poison , denaturates protiens.
• Used for preserving dead tissues.
• Use as antiseptic restricted due to bad odour
& irritation
• Glutaraldehyde is a better sterlizing agent
Acids
Boric acid
• weak antiseptic , bacteriostatic.
• used for mouth wash, irrigation eyes, glossitis.
• Adverse effect: vomiting ,abdominal pain on
systemic absorption.
Metallic salts
SILVER COMPOUNDS
• Silver sulphadiazine is active against
pseudomonas seen in burns patient.
• Silver nitrate highly active against gonococci
ZN SALTS
• Mild antiseptic, used as eye wash, ear drops.
Dyes
Gentian violet:
– Active against bacteria (gram + ve), fungi
– Used on chronic ulcers, furunculosis, bed sores,
ring worms.
Acriflavine
– Active against gram +ve bacteria & gonocci
– suitable for chronic ulcers & wounds
– Do not retard healing, non irritant
Ectoparasiticides
• These are drugs used to kill parasites that live

on body surfaces
lice → cause pediculosis (hair infection)
mites → cause scabies(skin infection)

Drugs used are
(1) PERMETHRIN
(2) LINDANE
(3) BENZYL BENZOATE
(4) IVERMECTIN
(5) CROTAMITON
(6) SULFUR
Permethrin
• Broad spectrum causes neurological paralysis in
insects.
• 100 % cure rate nearly
• Single application needed in most cases.
• Few patients experience itching ,burning.
• first drug of choice for scabies & pediculosis.
Scabies: apply all over the body except face &
head . Wash after 8- 12 hrs.
Head louse: massage about 30 g in to scalp and
wash after 10 min.
Lindane
• Broad spectrum insecticide which kills lice and
mites by penetrating their chitinous cover
• Properties similar to permethrin.
• Cure rate low & resistance seen.
• Disadvantage: being lipid soluble CNS toxicity like
vertigo , convulsions seen.
• Application similar to permithrin.
• combination with benzyl benzoate is more
effective.
Benzyl benzoate
• Oily liquid with aromatic smell.
• Cure rate 76 – 100% ; second application required
after 24 hrs.
• Toxicity is low. Application similar to permethrin.
• Use has declined due to skin irritation.
• Contra indicated in children because of
neurological symptoms & skin irritation.
• combination with lindane highly effective.
Crotamiton
• low cure rates
• Better results if applied for 5 days in children
• Less irritation and toxicity
• May be preferred in children as second choice
Ivermectin
• Anti helminthic drug which has been recently
found effective against scabies & pediculosis.
• A single 0.2 mg /kg ( 12mg in adults) has 91-
100 % cure rate.
• Contra indicated in children 5yrs ,
preganant & lactating women.

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ANTISEPTICS & DISINFECTANTS

• Detergents: Cidal to bacteria, fungi & viruses.

• These are drugs used to kill parasites that live

lice → cause pediculosis (hair infection)

mites → cause scabies(skin infection)

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