Antiseptics

&
Disinfectants

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 -:Introduction:-
Antimicrobial:- the substances derived from natural or
synthetic sources that kills or inhibit the growth of micro-
organism such as bacteria, fungi, protozoas

Germicides:- a group of drugs that are able to inhibit the

growth, development or leads to death of microorganisms in
the environment surrounding the patient or on the surface
of the body.
 Specially agents which inhibits or kills microbes on
contact
 They have low margin of safety
 Non-systemic use
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 Non selective Antimicrobial agents
 Germicides
Germicides

ANTISEPTICS DISINFECTANTS

ANTISEPTICS:- (Anti= against; septicas – emitting a fetid

smell)
Chemical substances which are used to destroy, inhibit
pathogenic bacteria (not the spores) on animate (living)
surface such as skin, eye, mucous membranes(as in mouth
washes).
1879- Lister- Father of ‘Antiseptic surgery’
They falls under “ Drug Control Agency of the Government”
 DISINFECTANTS
• Chemical substances or germicides which are use to destroy
or inhibit the growth of pathogenic vegetative bacteria (not
their spores) on inanimate(non-living) surface such as
glassware's or surgical instruments.
e.g.- Formaldehyde, phenol, ethyl alcohol, soaps.

 They falls under “Control of Environmental protection

agency of the Government”

 They process “concentration dependent killing”

 Antiseptics & Disinfectant are often added to easily
available every day utilities like soaps,toothpastes,mouth
wash, after saving lotion.
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 -:Some ancillary terms:-
1.Sterilization:-
Definition:- freeing an article, a surface or a medium by
removing or killing all micro-organisms including
vegetative bacteria, Spores, fungi & viruses

 usually sterilization is affected by autoclaving at 15lb

pressure of stream at 120oC for atleast 30 min
[It is the ultimate goal of any infection control protocol]
 Other methods also include-
o Infra-red(IR)-radiation,
o Ultraviolet(UV)-radiation
o γ-radiation
2. Decontamination:-
Marketed destruction of viable pathogenic organisms to a
level that will allow a healthy person’s natural
defenses to prevent any infection.
e.g.- Decontamination of water

3.Sanitisation:- reduction In microbial load from an

inanimate surface to a level set forth by public health
Department of Environmental Agency
 These levels are considered acceptable for the health of
the population
4. Pasteurisation:-
Process of heating milk or other liquids or semisolids for
about 30 min at 60-80oC which kills the non-
sporulating microorganism and prevents the growth of
food-borne pathogens for a specific period of time.

5.Preservation:-
To preserve the efficacy & to prevent the deterioration of
the drug formulation up to its expiry period.
A Preservatives may protect the drug from oxidation.
e.g.-Benzyl Alcohol(2%),Benzoic Acid & its salts (0.2%)

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 -:IDEAL Antiseptics/Disinfectant:-
• High Efficacy:
– Broad spectrum / sporicidal / kill all forms
– Rapid onset / long duration action
– Cidal not static
– Active in presence of blood, pus,exudates and
excreta
– No Resistance
• Non Toxic:
– Non-irritating to tissues,should not delay healing.
– Non absorbable / No hypersensitivity
– Chemically stable.
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 IDEAL ANTISEPTICS :
• Added Advantage:-
– Non-staining with agreeable color and odour
– Could be added to soaps
– Non corrosive.

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 MECHANISM OF ACTION:

1. Oxidation of Bacterial protoplasm.

e.g.- KMn04, H202, Halogens
2.Denaturation of Bacterial Proteins & Enzyme
e.g.-Phenols, Chlorhexidine, Alcohol, Aldehyde
3.Detergent like action increasing permeability
of bacterial membrane
e.g.- Soaps,Cetrimide

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 FACTORS MODIFYING ACTION
• TEMPERATURE AND pH.

• PERIOD OF CONTACT WITH MICROBES.

• NATURE OF MICROBES INVOLVED.

• SIZE OF INNOCULUM

• PRESENCE OF BLOOD,PUS,OR ORGANIC

MATTER.
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 General Uses of Antiseptics/ Disinfectants
• Asepsis before injections:-
• Surgical Uses:-
– Asepsis before surgery
– Scrubbing
– Sterilization of the surgical instruments
• Cuts, wounds & Lacerations
• Disinfection of Hospital premises
• Water purification & domestic disinfection

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CLASSIFICATION :-‘PHAARMA
:- GOD’
• PHENOL DERIVATIVES:-
Phenol,Cresol,Hexylresorcinol,Hexachlorophene
• HALOGENS:-Iodine, Iodophores, Chlorine, Chlorophores
• ALCOHOLS:-ethanol , Isopropanol.
• ALDEHYDES:- Formaldehyde, Glutaraldehyde
• SURFACE ACTIVE AGENTS:-
• QUATERNARY AMMONIUM (CATIONIC):-
Cetrimide, Benzalkonium chloride, Dequalinium chloride.
BIGUANIDE:- Chlorhexidine
• SOAPS:- OF sodium & Potassium

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• METALLIC SALTS:- Silver nitrate, Silver
sulfadiazine, Mild silver protein, Zinc sulfate,
Calamine, Zinc oxide.
• ACIDS:- Boric acid, Acetic acid
• GASES:- Ethylene oxide
• OXIDIZING AGENTS:- KMno4,Hydrogen peroxide,
Benzoyl peroxide

• DYES:-
YES GENTIAN VIOLET, METHYLENE BLUE
BRILIANT GREEN, ACRIFLAVIN AND PROFLAVIN

• MISCELLANEOUS:- NITROFURAZONE 14
 PHENOL DERIVATIVES:
• PHENOL (CARBOLIC ACID):-
• One of the earliest used Antiseptics & still the standard for
comparing other germicides.
• Weak agents Static at- 0.2% Bactericidal at >1%,
• Poor action bacterial spore
• Protoplasmic poison
MOA:- Denatured bacterial protein (irritant/toxic to tissues)
-Mild LA action- use as Antipruritic Preparation
USES: Disinfectant of Urine,faeces pus,sputum,antipruritic
preparation mouth wash.

Side effect:-Buccal, esophageal, gastric burns, scars/strictures

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CRESOL (METHYL PHENOL):-
• X3 potent than Phenol / less damage to tissues
• USES:- Disinfecting of utensils, Excreta, for washing
hands, irrigation of root canals.
CHLOROXYLENOL(DETTOL):-
• Non-corrosive, Non-irritating to intact skin, No stain,
 4.8% commercial use “Dettol”(9% terpinol+13% Alcohol)
 6.25%- Instruments
 Cream & Soap,
 Lubricating obstetric cream (1.4% ).
• USES:-
Surgical Antiseptics , skin cream, mouth wash, soaps, wounds
& cuts
• HEXACHLOROPHENE:
• POTENT CHLORINATED PHENOL
• Odourless, non staining, non irritant (+soaps)
• Sustained action
• Good- Gm+ve/ Poor- Gm-ve & spores
• USES:-
USES ANTISEPTICS FOR SURGICAL SCRUB,
TOILET PRODUCTS & DEODRANTS, Skin infections
(Furunculosis/ Carbuncle), baby bath products (<2%).
• Side effect:- Neurotoxicity (Neonates)->2%- BAN.

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 Phenol Derivatives (contd.)
• Triclosan:-uses- Liquid soaps, Dentifrices, mouth wash
• Thymol:-
– Antiseptic / mild LA effect
– Uses- cough drops / Dentifrices / Acne / mouth wash
• Resorcinol- less potent than Phenol
• Uses- Antiseptic (ringworm, acne, ), keratolytic &
antipruritic effect (Seborrhoeic dermatitis, Eczema,
Psoriasis
• Hexylresorcinol- mouthwash

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Contains are
menthol,
thymol,
methyl salicylate, and
eucalyptol

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 OXIDIZING AGENTS:-
• POTASSIUM PERMAGNATE:-
• HIGHLY WATER SOLUBLE.
• Nascent [O]-OXIDIZES BACTERIAL PROTOPLASM.
USES:- 1:4000-1:10,000 SOLN (CONDY’S LOTION)-
– Antiseptic(Mouthwash/GARGLING/DOUCHING, IRRIGATING
CAVITIES/ wounds/ Atheletes foot (1%)
– Domestic use-DISINFECTION OF utensils/ vegetables/ fruits/
purification of WATER (ponds/ wells)
– GASTRIC LAVAGE (in alkaloidal poisoning)
– Styptic (5%)
• Side effect:- BURNS,BLISTERING /stain / Rusting /
sensitve to light.

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 OXIDIZING AGENTS:
H2O2 – Adv.-
– Non-toxic/ colorless/ odourless
– Effective against anaerobic bacteria
• Demerits-
– Weak antiseptic
– To be kept in dark bottles
• Uses-
– Dental use- Mouthwash (3%)- dilute with water- stomatitis/ cavity
preparation
– Bleaching agent (for teeth stains)- 30% H2O2 + glycerine+ pumice
– Surgical use (3-6%)- wound cleaning / slough remove
– Removal of ear wax
– Deodorant
– Styptic (25-30%)
• BENZOYL PEROXIDE:-
• Liberate 02,killsAnerobic,microaerophilic bacteria
Keratolytic & comedolytic properties-(To
properties- remove
warts and other lesions in which the epidermis
produces excess skin)
• USES:-ACNE (2.5-10% cream), ANTISEPTICS.
ADVERSE EFFECTS:-
Burning,
stinging sensation,
localized erythmia,
dryness of skin,
SCALING EDEMA.
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 HALOGENS:-
HALOGENS:
Chlorine & Cl-
IODINE & I- releasing releasing agents:
agents:
• Rapid action
• Rapid action
• Broad spectrum
• Broad spectrum
• readily inactivated by
• Not readily inactivated
organic matter
by organic matter
• MICROBICIDAL
• MICROBICIDAL
AGENT,
AGENT, IODINATES
CHLORINATES AND
AND OXIDIZES
OXIDIZES
MICROBIAL
MICROBIAL
PROTOPLASM
PROTOPLASM
 HALOGENS:-
HALOGENS:
• IODINE:
USES: (1:20,000 , SOLN KILL VEGETATIVE FORM- ANTISEPTIC
USES)
1.TINCTURE IODINE (2.5% IN ALCOHOL)
2.MANDL’S THROAT PAINT (1.25% IN POT .IODIDE) FOR
SORE THROAT.
3.COUNTER IRRITANT
4. WATER PURIFICATION.
ADRs: CORROSIVE,BURNS,BLISTERS, RASHES, stain,
irritant, less duration of action
• To be kept in dark colored bottles.

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IODOPHORES:-
• SOLUBLE COMPLEX OF IODINE.
• Slow RELEASE of FREE IODINE
• NON-IRRITATING,NONTOXIC,Non staining
• USES:- POVIDONE IODINE (POLYVINYL
PYRROLIDONE Iodine)-
– FOR BOILS,FURUNCULOSIS,BURNS,OTITIS
EXTERNA, ULCER,VAGINITIS,SURGICAL
SCRUBBING,DISINFECTION OF ENDOSCOPIC
INSTRUMENTS, Tinea infections (5%- cream, solution,
Ointment
– Dental uses- Mouth wash/ Gargle (2%)
– Analgesic (Iodine (4%) creams- analgesics}

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• CHLORINE:-
• HIGHLY REACTIVE
• POTENT GERMICIDE
• USES: DISINFECTION OF URBAN WATER SUPPLIES
(Cl2 gas- 0.2- 0.4ppm)
• CHLOROPHORES:-
• COMPOUND RELEASES hypochlorous.
• TYPES:-1.CHLORONATED
TYPES:- LIME (BLEACHING
POWDER)
• USES:
• Disinfection of drinking water,
• Swimming pool
• Sanitizer
• Tooth stains removal 26
2.SODIUM HYPOCHLORITE SOLN:-
USES:(4-6%) DISINFECTANT IN DAIRIES FOR MILK CANS, Lab
disinfectant, Biohazard Spill management,
EQUIPMENTS,ANTISEPTIC,ROOT CANAL THERAPY, also used
as Bleaching agent in dentistry
• 3.DAKIN SOLN: DILUTE SOD. HYPOCHLORITE BUFFERED
WITH BORIC ACID.
• 4.EUSOL: (chlorinated lime 1.25%+Boric acid).
• USES:-
Dissolving pus,
Blood clots,
Necrotic matter,
Clean infected wound,

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 -:QUATERNARY AMMONIUM
(CATIONIC ANTISEPTICS):-
• Detergents,Cidal to bacteria, Fungal &viruses, non
irritating, mild keratolytic.
• USES:- Sanitizer, Antiseptics, Disinfectant for surgical
instrument, gloves.
• CETRIMIDE:-
• soapy powder with faint ,fishy odors
• wound clearing from dirt ,skin disinfectant,
• Anti-plaque agent,
• As antiseptics, Surgical instruments, utensil

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• Cetyl pyridinium Chloride- mouth wash, antiplaque agent,
Lozenges
• Benzalkonium Chloride- storage of sterile surgical
instruments
• SOAPS:-
• Anionic detergents, weak Antiseptics
• Sod. Or Pot. Salts of large chain fatty acids
• Emulsifying agents.
• Affective against-gm+Ve
• USED FOR CLEANSING ACTION
• Sodium Lauryl sulphate.
sulphate

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 -:CHLOROHEXIDINE:-
• Cationic biguanide which highly Powerful, on-irritating, colorless,
odorless antiseptics
• Spectrum of activity:-
Active against gm+ve bacteria
Moderately active against –gm-ve bacteria

MOA:- Disrupt bacterial membrane.

• Effective in the presence of pus, blood, organic matter.
• Exhibits residual activity after repeated use
• Savlon liquid antiseptics:- Chlorhexidine gluconate 1.5% +
cetrimide 3% exhibits enhanced efficacy
• Formulation available:- lotion,
Cream,
Washes, Aqueous solution 30
(Savlon is a combination
of Chlorhexidine gluconate
& cetrimide)

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USES:-
 Bath, Neonatal bath, surgical scrub,
 Dental use-
 mouthwash including candidiasis (0.1-0.2% mouth wash)
 Aqueous solution In mouth wash-↓dental plaque accumulation
 Obstetrics (1% cream) & skin antiseptics & clearing of
wounds(0.05% aqueous solution)
 Preoperative clearing of skin(0.5% solution in 70% alcohol)
 Anti-plaque agent(prevent periodic disease)
 In catheterisation & cystoscopy- gel (0.25%
chlorhexidine+xylocaine)
 Disinfection of hydrophilic contact lenses-0.002-0.005%
chlorhexidine

Side effects:- Yellow brown stain, Altered taste, mucosal soreness

 -:ALCOHOLS:-
MOA- ppts bacterial proteins /cidal
• ETHANOL:
• EFFECTIVE ANTISEPTIC on skin (not on muc.
Membrane) / rapid action
• CLEANSING AGENT AT 40-90% CONC.
• ADRs: BURNING SENSATION,INJURY, irritant on
Muc. membranes.
• Uses- wounds/ cuts, degerming of skin before injections
(Isopropyl alcohol)

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 ALDEHYDES:
• MOA- DENATURES BACTERIAL PROTEINS.
• PROTOPLASMIC POISON.
• FORMALDEHYDE (Formalin): slow antiseptic,
broad spectrum, sporicidal
• USES:
Disinfection of surgical instruments (2-8%),
Preservation of dead tissue samples (4% aqueous
Solution),
fumigation, urinary antiseptic (Methenamine)
• ADRs: ECZEMATOID REACTIONS, irritates,No oral
use.

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 ALDEHYDES:
• GLUTARALDEHYDE:
 Sterilizing agents
 Less irritating
 Less pungent ,
 Broad spectrum ,not inactivated by Bio fluids,
 Activated at alkaline pH.
• USES:
1. Cold sterilization- Disinfection of surgical instruments ,
Endoscopes (to be kept for 12 hrs)
2. Hospital disinfectant of premises / OTs

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 Acids:-
• BORIC ACID:-
• Bacteriostatic & Weak antiseptics ,
• Non irritating
• USES:-
• Irritating eyes (4%),
• Mouth washes
• Boroglycerin paint (30%)- stomatitis ,Glossitis
2.CUTS AND ABRASION (10%),
3.PRICKLY HEAT POWDERS,EAR
DROPS,IRRIGATING BLADDER.
• ADRs:- vomiting ,Abdominal pain Diarrhoea, visual
& kidney damage 36
• ACETIC ACID:- Oldest antiseptic,
BACTERICIDAL – FOR BURN
DRESSING(>5%),
effective against Pseudomonas.

• Salicylic acid- Bacteriostatic, Keratolytic (>

( 25%),
Fungicidal (3%- Whitfield Oint.)

• Benzoic acid- Fungistatic (6%- Whitfield Oint.)

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 METALLIC SALTS:-
Mercury compounds:-
• Bacterioststics & Poor antiseptics
• Low TI
• INACTIVATES SH-ENZYMES.
• 1.AMMONIUM MERCURY:
• 5-10% ointments, dermatophytosis
• Anal purities

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• 2.PHENYL MERCURIC NITRATE:
USES: IN TINEA REMEDIES,ANORECTAL
PREPARATIONS, OTIC, OCULAR
PREPARATIONS & PRESERVATIVES.

MERBROMIN (Mercurochrome):
• BRIGHT RED, ORGANIC MERCURIAL.
• NON-IRRITATING & LESS TOXIC.
• USES: 1-2% FOR EYES AND SKIN
antiseptic.
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 SILVER COMOUNDS:
• ASTRINGENT & CAUSTIC.
• REACT WITH -SH,-COOH,-PO4,-NH2 PROTEINS.
• SILVER NITRATE (slow Ag release)
• RAPIDILY KILLS MICROBES.
• USES: Opthalmia Neonatarum (1% soln.) SOLN.,
APTHOUS ULCER
• Demerits: black discoloration of tissues
SILVER SULFADIAZINE:
• No black discoloration.
• USES: AS OINTMENT IN BURNS / effective in
Pseudomonas inf..
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 ZINC SALTS:
• ASTRINGENT & MILD ANTISEPTICS.

• 1.ZINC SULFATE: WATER SOLUBLE.

• USES: EYE & EAR DROPS, Mouth wash,
EYE WASH, FOR ACNE AND IMPETIGO,
Lotiocalamine (Zno + Calamine), Anti Perspirants.

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 DYES:
• Complex organic substances derived from coal tar
• Gentian violet (crystal violet):
• Rosaniline dye.
• Active against staphylococci,gram +ve bacteria, fungi.
• Uses: alcoholic soln (0.5%) for furunculosis, bed sores,
chronic ulcers,infective eczema, thrush, ringworm.
• Demerits- poor efficacy against Gm-ve & in the
presence of pus, blue stain on skin

Briliant green :-rosaniline dye.

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• Acridine Dyes: Acriflavin and Proflavin:
• Orange-yellow acridine dyes
• Active against gram + ve bacteria &gonococci.
• Sensitive to light & lose efficacy
• Effective in alk. pH
• Non irritant.
• Uses: chronic ulcers,wounds, burn dressings, Triple dye
lotion-gentian violet 0.25%+briliant green 0.25%+
acriflavin 0.1% for burns. Dressing in umbilical stump in
neonates.
• Demerits- to be stored in amber coloured bottles

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 FURAN DERIVATIVES:
• Nitrofurozone:
• Cidal for gram +ve & gram –ve,aerobic
&anaerobic bacteria.

• Inhibits enzymes for carbohydrates metabolism.

• Use- Efficacious in burns,skin grafting.

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Chronic Toxicity- Skeletal Fluorosis

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