Antiseptic Drugs and Disinfectants

Abstract

This review of the January 2012 to June 2013 publications on adverse reactions to antiseptic drugs and disinfectants covers aldehydes (formaldehyde and glutaraldehyde), guanidines (chlorhexidine, polyhexamethyleneguanidine and polyhexamethylene biguanidine), benzalkonium compounds, ethylene oxide, triclosan, halogens (sodium hypochlorite, tosylchloramide, and the iodophors iodine, polyvinylpyrrolidone, and povidone-iodine), and phenolic compounds (phenol, thymol, and methyl salicylate). Antiseptic drugs and disinfectants continue to be used in a variety of medical and occupational settings, in certain cosmetic products as well as in the household. A novel observation was the toxicity of polyhexamethyleneguanidine (PHMG). When used as a disinfectant for sterilization of household humidifiers, PHMG caused lung disease, and 28 fatal cases were reported. In Russia, where PHMG containing disinfectants were abused as surrogate alcohol, the compound was associated with causing cholestatic hepatitis different from the conventional chronic hepatitis induced by ethanol. The respiratory effects and carcinogenicity of the sterilizing agent formaldehyde are still an important subject, as is the mutagenicity of ethylene oxide especially in occupational settings. Adverse reactions to chlorhexidine were described in a number of publications including contact dermatitis and several cases of anaphylaxis. Iodine and povidone-iodine are also well-established topical antiseptics, but they continue to cause adverse reactions, including allergic reactions and effects on thyroid function. Antiseptics and disinfectants are also used as preservatives and antimicrobials in numerous pharmaceutical formulations and personal care products, and their safety continues to be evaluated. Benzalkonium chloride as a preservative in eye drops can cause allergic reactions and inflammation.