Infection control Antiseptics and disinfectants Antiseptics and disinfectants

Antiseptics are considered as medications capable of eliminating and killing the microorganisms or inhibiting their growth and development. Antiseptics are biocides or germicides or products that destroy or inhibit the growth of microorganisms in or on living tissues.

Disinfectants Are similar but generally are products or biocides that are used on inanimate objects and surfaces. Disinfectant can be sporostatic but not necessarily sporocidal.

Biocide is a general term describing a chemical agent, usually broad spectrum that inactivates microorganisms.

Biocides Usually ranges in antimicrobial activity, so other terms are more specific.

Antibiotics: are defined as naturally occurring or synthetic organic substances, which inhibit or destroy selective bacteria or other microorganism. Sterilization Refers to a physical or chemical process that completely destroys or removes all microbial life, including spores.

Antiseptics Antiseptics should not be used on wounds or on open skin or mucus membranes. »Respect the expiry date of each antiseptic used. » An antiseptic solution can be the object of microbial contamination,and can become the cause of spreading infection.

General recommendations In general after opening an antiseptic: 1. Put the date on antiseptic when it was opened. 2. An alcoholic solution can be conserved one month only. 3. Clean the bottle Well each day from outside. 4. Keep all antiseptic far away from direct light and source of heat. 5. Always respect the duration of contact and concentration. {e.g. Chlorocept}

Characteristics of certain antiseptics : The selection of appropriate antiseptic depends on: *Absence of absorption across the skin or mucus membrane. *Persistence, rapid reduction in the flora. *Mode of action and spectrum of activity. *Efficacy in reducing microbial count. *Personnel acceptance.

Alcohol: ethly alcohol (ethanol),isopropyl alcohol (isopropanol). ● Exhibitis rapid broad- spectrum anti-microbial activity. ● Excellent bactericidal activity against most gram +ve and gram-ve micro-orgainsms. ● Good activity against the tubercle Bacillus.

● Acts against many fungi and viruses. (Hepatitis B virus and HIV). ● Appropriate concentrations alcohol provides the most rapid and greatest reduction in microbial count of skin. ● Alcohol application as short 15 seconds in duration have been effective in preventing hand transmission of gram -ve bacteria.

● A 3 minutes rubbing with alcohol are as effective as a surgical hand scrub. ● Alcohol concentration between 60-70% is most effective generally 70% is used because it causes less skin drying and less chemical dermatitis.

Chlrohexidine: Hibiscrub, septal scrub, anios etc. ● It has a broad spectrum of activity against gram +ve and gram –ve. ● It is a bactericidal agent. ● Action against the tubercle bacillus is minimal. ● A fair inhibitor of fungi and is active against viruses. Chlrohexidine: Hibiscrub, septal scrub, anios etc. ● It has a broad spectrum of activity against gram +ve and gram –ve. ● It is a bactericidal agent. ● Action against the tubercle bacillus is minimal. ● A fair inhibitor of fungi and is active against viruses.

● Not as rapid action as Alcohol but there is significant reduction in flora after 15 second of hand wash so used for aseptic hand wash. ● Has good affinity for skin and remains active for at least 6 hours. ● After daily use bacterial yield from hands is low.

● Could be associated with alcohol combining the rapid action of alcohol and the persistence of chlorehexidine. ● Chlorhexidine is non-toxic in general because skin absorption is minimal. ● Ototoxicity can result if directly instilled in middle ear. ● Corneal damage can result from installation into the eyes. ● Could be associated with alcohol combining the rapid action of alcohol and the persistence of chlorehexidine. ● Chlorhexidine is non-toxic in general because skin absorption is minimal. ● Ototoxicity can result if directly instilled in middle ear. ● Corneal damage can result from installation into the eyes.

Iodine and iodophores: Iodine ● It has been used as pre-operative skin preparation for years. ● Relatively safe and fast acting. ● Not commonly used for hand washing. ● It must be removed from the skin after drying because of its potential to cause skin irritation.

Iodophores ● Are iodine-containing products that are used for hand washing and surgical hand scrub. ● They are complexes that consist of iodine and povidine (A carrier iodine that increases solubility and provides a reservoir for iodine e.g.,a 10% povidine iodine). ● Both iodine and Iodophores have a wide range of activity against gram+ve & gram-ve bacteria, TB,fungi and viruses.

● Iodine and to alesser extent the iodophores are characterized by a propensity toward skin irritation and damage as well as Allergic or toxic effects in sensitive persons. ● Sometimes absorption from mucus membrane occurs, possible induction of hypothyroidism.

What is the ideal antiseptic? 1. Should have a large anti-bacterial activity and also active against viruses and fungus. 2. Should be bactericidal and not only bacteriostatic. 3. Should work quickly with a prolonged action and accumulative effect after several uses. 4. To have a localized action.

5.Not to be irritant or toxic to tissues or to the environment. 6.To be soluble in water. 7.Not to be affected or inhabited by organic materials. (Blood, pus etc.). 8.To be stable.

 Although numerous disinfectants are available, no single agent or preparation is ideal for all purposes.  Consideration should be given to the agent and its special use, as well as to the organisms likely to be contaminating the object that is to be disinfected

 Special precautions should be given to the recommended concentration of each disinfectant and to its time of exposure.  Unnecessary exposure of neonates to disinfectant should be avoided.  Strict adherence to manufacturers recommendation is essential.