Antiseptic drugs and disinfectants with special scrutiny of COVID-19 pandemic related side effects

Abstract

This review covers publications during the period of January 2020 to December 2020 on adverse reactions to antiseptic drugs and disinfectants. Specific agents discussed are alcohols (ethanol, isopropanol), aldehydes (formaldehyde), guanidines (chlorhexidine, polyhexamethylene guanidine, and polyhexamethylene biguanidine), benzalkonium compounds, triclocarban, povidone-iodine, and sodium hypochlorite. No new data were identified for glutaraldehyde, cetrimide, ethylene oxide, tosylchloramide, triclosan, iodine, and phenolic compounds. The use of antiseptic drugs and disinfectants has been considerably increased during 2020 in a variety of medical and occupational settings, in commerce and gastronomy, as well as in the household, due to their antiviral properties against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the Coronavirus Disease 2019 (COVID-19) pandemic. Exposure was additionally increased by widespread misinformation on social media for non-evidence based disinfectant use, even including ingestion or injection, as well as by questionable practices such as environmental spraying or disinfectant gates. Irritant effects on the respiratory system, skin and eyes were the most common adverse reaction, while the widespread and sometimes excessive use led to increased reports of poisonings, as well as cases of disinfectant adulteration including dilution into ineffective concentrations or addition of toxic agents such as methanol.