Antiseptic Cream Research Articles

Radiofrequency coagulation versus liquid paraffin plus antiseptic cream in the treatment of recurrent anterior epistaxis

ObjectivesTo evaluate the efficacy of radiofrequency coagulation and to compare it with that of liquid paraffin plus antiseptic cream in the management of recurrent anterior epistaxis. DesignProspective clinical trial. Between February 2011 and July 2012, one hundred consecutive patients with histories of recurrent anterior epistaxis were randomly assigned to receive treatment consisting of either a combination of liquid paraffin plus antiseptic cream (group 1) or radiofrequency coagulation (group 2). SettingBenha University Hospital. Main outcome measuresThe Epistaxis Severity Score; before treatment, at 4, 12weeks, 6 and 12months after treatment, participant’s perception of discomfort during the management and complications. ResultsThe severity score of the 94 patients who had full data at 4weeks after treatment shows no statistically significant differences between the two groups. However, at 12weeks; 85% of the radiofrequency group versus 40% of paraffin-antiseptic group patients had reported no bleeding. At 6months; 74% of the radiofrequency group versus 25% of the paraffin-antiseptic group patients reported no bleeding. At 12months, 70% of the radiofrequency group versus 23% of the paraffin-antiseptic group patients reported no bleeding. Both groups had no complications. The level of pain associated with the procedure was tolerable. Mean duration of the radiofrequency procedure was 14.2min. ConclusionsIt can be concluded that radiofrequency coagulation is a safe, convenient rapid and simple procedure that is associated with a significant improvement in epistaxis severity in cases of recurrent anterior epistaxis. This therapy could be performed in office settings.

Enrichment, Development, and Assessment of Indian Basil Oil Based Antiseptic Cream Formulation Utilizing Hydrophilic-Lipophilic Balance Approach

The present work was aimed to develop an antiseptic cream formulation of Indian basil oil utilizing hydrophilic-lipophilic balance approach. In order to determine the required-hydrophilic lipophilic balance (rHLB) of basil oil, emulsions of basil oil were prepared by phase inversion temperature technique using water, Tween 80, and Span 80. Formulated emulsions were assessed for creaming (BE9; 9.8, BE10; 10.2), droplet size (BE18; 3.22 ± 0.09 μm), and turbidity (BE18; 86.12 ± 2.1%). To ensure correctness of the applied methodology, rHLB of light liquid paraffin was also determined. After rHLB determination, basil oil creams were prepared with two different combinations of surfactants, namely, GMS : Tween 80 (1 : 3.45) and SLS : GMS (1 : 3.68), and evaluated for in vitro antimicrobial activity, skin irritation test, viscosity and consistency. The rHLB of basil oil and light liquid paraffin were found to be 13.36 ± 0.36 and 11.5 ± 0.35, respectively. Viscosity, and consistency parameters of cream was found to be consistent over 90 days. Cream formulations showed net zone of growth inhibition in the range of 5.0–11.3 mm against bacteria and 4.3–7.6 mm against fungi. Primary irritation index was found to be between 0.38 and1.05. Conclusively stable, consistent, non-irritant, enriched antiseptic basil oil cream formulations were developed utilizing HLB approach.

Outcome of Burn Management in Bangkok Hospital

OBJECTIVES. To report the result of major burn treatment in Bangkok Hospital. MATERIALS AND METHODS. All major burn cases were debrided and dressed with antiseptic procedures and antiseptic cream under supervised teamwork. We retrospectively reviewed all cases from July 2007 to December 2010. RESULTS. Sixty burn patients, the average age 33.17 year percent of total body surface area (% TBSA) was 34.9, Baux score was 74.93.

Interventions for recurrent idiopathic epistaxis (nosebleeds) in children

Recurrent idiopathic epistaxis (nosebleeds) in children is repeated nasal bleeding in patients up to the age of 16 for which no specific cause has been identified. Although nosebleeds are very common in children, and most cases are self limiting or settle with simple measures (such as pinching the nose), more severe recurrent cases can require treatment from a healthcare professional. However, there is no consensus on the effectiveness of the different clinical interventions currently used in managing this condition. To assess the effects of different interventions for the management of recurrent idiopathic epistaxis in children. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 5 March 2012. We identified all randomised controlled trials (RCTs) (with or without blinding) in which any surgical or medical intervention for the treatment of recurrent idiopathic epistaxis in children was evaluated in comparison with either no treatment, a placebo or another intervention, and in which the frequency and severity of episodes of nasal bleeding following treatment was stated or calculable. The two authors reviewed the full-text articles of all retrieved trials of possible relevance and applied the inclusion criteria independently. We graded trials for risk of bias using the Cochrane approach. One author performed data extraction in a standardised manner and this was rechecked by the other author. Where necessary we contacted investigators to obtain missing information. We did not undertake a meta-analysis because of the heterogeneity of the treatments, procedures and quality of the included trials. A narrative overview of the results is therefore presented. Five studies (four RCTs and one quasi-randomised controlled trial) involving 468 participants satisfied the inclusion criteria. The identified RCTs compared 0.5% neomycin + 0.1% chlorhexidine (Naseptin®) cream with no treatment, Vaseline® petroleum jelly with no treatment, 75% with 95% silver nitrate nasal cautery, and silver nitrate cautery combined with Naseptin® against Naseptin® alone; the quasi-randomised controlled trial compared Naseptin® antiseptic cream with silver nitrate cautery. Overall results were inconclusive, with no statistically significant difference found between the compared treatments upon completion of the trials, however 75% silver nitrate was more effective than 95% silver nitrate at two weeks following application. The group treated with 75% silver nitrate had 88% complete resolution of epistaxis compared to 65% in the group treated with 95% silver nitrate (P = 0.01). No serious adverse effects were reported from any of the interventions, although children receiving silver nitrate cautery reported that it was a painful experience (despite the use of local anaesthetic). The pain scores were significantly less in those treated with 75% silver nitrate, the mean score being 1 compared to a mean score of 5 in those treated with 95% silver nitrate; this was statistically significant (P = 0.001).We carried out a 'Risk of bias' assessment of each study according to the Cochrane methodology and judged that two randomised controlled trials had a low risk of bias, two had an unclear risk of bias and the quasi-randomised controlled trial had a high risk of bias. The optimal management of children with recurrent idiopathic epistaxis is unknown, however if silver nitrate nasal cautery is undertaken 75% is preferable to 95% as it is more effective in the short term and causes less pain. High-quality randomised controlled trials comparing interventions either with placebo or no treatment, and with a follow-up period of at least a year, are needed to assess the relative merits of the various treatments currently in use.

A prospective randomised controlled trial of Nd:YAG laser photocoagulation versus liquid paraffin plus antiseptic cream in the treatment of recurrent epistaxis

To evaluate the efficacy of Nd:YAG laser photocoagulation with that of liquid paraffin plus antiseptic cream in the management of recurrent epistaxis. Prospective clinical study. Eighty consecutive patients with histories of recurrent epistaxis were randomly assigned to receive treatment in an outpatient setting consisting of either a combination of liquid paraffin plus antiseptic cream (group 1) or Nd:YAG laser photocoagulation (group 2). University-affiliated teaching hospital. Eighty consecutive patients who suffered from recurrent anterior epistaxis presented to the Otolaryngology Department at the Eye and ENT Hospital, Fudan University between February 2011 and June 2011. The following outcome measures were assessed: bleeding intensity, bleeding frequency 4 and 12 weeks after treatment (0 = no bleeding, 1 = reduced bleeding, 2 = the same, 3 = worse), participant's perception of discomfort during the management (grade 0-10, where 10 is the worst pain) and complications. At 12 weeks, 85% of laser patients versus 40% of control patients had no reported bleeding. The outcome score at 4 weeks after treatment showed no significant difference between the two groups (P = 0.130, P > 0.05); however, the outcome score at 12 weeks after treatment showed a significant difference between the two groups (P = 0.000, P < 0.01). The median and mean ± sd pain levels experienced were 5.0 and 5.2 ± 2.2. Both groups had no complications. It can be concluded that Nd:YAG laser photocoagulation is a preferable therapy in the treatment of recurrent epistaxis, especially in terms of long-lasting efficacy. The level of pain associated with the procedure was tolerated. It is a simple, easy, safe and rapid therapy, which can be performed in an office setting.

Effect of different pharmaceutical vehicles on antimicrobial action of essential oils

The aim of present work was to investigate the effect of different pharmaceutical vehicles on antimicrobial action of essential oils. Based on preliminary antimicrobial studies of essential oils from Patchouli (P), Geranium (G) and Coriander (R) in pure form as well as in mixture, three combinations (1:1) of oils were prepared and designated as P+G, G+C and C+P. Incorporating these combination of oils as active pharmaceutical ingredient (3% w/w), a variety of bases viz. base 1 and base 2 (hydrophilic ointment), base 3 (hydrophobic ointment), base 4 and base 5 (O/W emulsion), base 6 (light-liquid paraffin) and base 7 (Tween 80) were formulated and subjected to agar diffusion assay against a wide spectrum of gram positive and gram negative bacteria. For comparison a popular marketed antiseptic cream was also evaluated for antimicrobial activity. It was observed that base 1 showed promising bactericidal action (4–13mm) followed by marketed cream (2–8mm) and base 2 (1–6mm). Base 5 and base 6 exhibited bacteriostatic action whereas base 3, base 4 and base 7 did not show any antimicrobial activity. Divergence in antimicrobial action of essential oils into different pharmaceutical vehicles may be attributed to the release characteristic of oil to the outer environment (agar medium). Hydrophilic ointment facilitates release of oils in comparison to hydrophobic ointment base resulting into bactericidal action, whereas emulsification and solubilisation of essential oil caused diminished antimicrobial activity. Chemical binding of non-ionic surfactant Tween 80 with active ingredient may be responsible for loss of antimicrobial activity.

Is local ointment or cauterization more effective in childhood recurrent epistaxis

ObjectivesTo compare the efficacy of nasal antiseptic ointment and silver nitrate cautery in the treatment of children with recurrent epistaxis. MethodsIn this prospective and randomized study, a hundred children with recurrent epistaxis were assigned into two groups. In group 1, patients underwent silver nitrate cauterization, in group 2 patients were treated with nasal antiseptic ointment (oxytetracycline hydrochloride-polymyxin B sulfate); and both groups were followed for 3 months. All of the patients were investigated for allergy with skin prick test. ResultsThe ages of patients were similar in both groups (group 1: 9.2±2.7; group 2: 8.2±2.2; p=0.069). Thirty-eight percent of the patients in group 1 and 52% of the patients in group 2 had epistaxis in the three months follow-up. The difference between groups was not significant (p=0.159). Thirteen (26%) of the patients in group 1 and 12 (24%) of the patients in group 2 were found to have allergic symptoms and positive prick test. The rate of allergy was similar in both groups (p=0.817). ConclusionNasal antiseptic ointment and silver nitrate cauterization were found to have similar outcomes in the treatment of recurrent epistaxis.

A standardized protocol to reduce cerebrospinal fluid shunt infection: The Hydrocephalus Clinical Research Network Quality Improvement Initiative

Quality improvement techniques are being implemented in many areas of medicine. In an effort to reduce the ventriculoperitoneal shunt infection rate, a standardized protocol was developed and implemented at 4 centers of the Hydrocephalus Clinical Research Network (HCRN). The protocol was developed sequentially by HCRN members using the current literature and prior institutional experience until consensus was obtained. The protocol was prospectively applied at each HCRN center to all children undergoing a shunt insertion or revision procedure. Infections were defined on the basis of CSF, wound, or pseudocyst cultures; wound breakdown; abdominal pseudocyst; or positive blood cultures in the presence of a ventriculoatrial shunt. Procedures and infections were measured before and after protocol implementation. Twenty-one surgeons at 4 centers performed 1571 procedures between June 1, 2007, and February 28, 2009. The minimum follow-up was 6 months. The Network infection rate decreased from 8.8% prior to the protocol to 5.7% while using the protocol (p = 0.0028, absolute risk reduction 3.15%, relative risk reduction 36%). Three of 4 centers lowered their infection rate. Shunt surgery after external ventricular drainage (with or without prior infection) had the highest infection rate. Overall protocol compliance was 74.5% and improved over the course of the observation period. Based on logistic regression analysis, the use of BioGlide catheters (odds ratio [OR] 1.91, 95% CI 1.19-3.05; p = 0.007) and the use of antiseptic cream by any members of the surgical team (instead of a formal surgical scrub by all members of the surgical team; OR 4.53, 95% CI 1.43-14.41; p = 0.01) were associated with an increased risk of infection. The standardized protocol for shunt surgery significantly reduced shunt infection across the HCRN. Overall protocol compliance was good. The protocol has established a common baseline within the Network, which will facilitate assessment of new treatments. Identification of factors associated with infection will allow further protocol refinement in the future.

Epistaxis: update on management

This article reviews the literature on epistaxis, with a focus on the past 12-18 month, and aims to classify the literature available for this very common otolaryngology emergency. Epistaxis can be classified into primary or secondary epistaxis based on cause. It can also be classified as childhood and adult epistaxis. These classifications are useful clinically, as the management of each group is different. Primary epistaxis should be managed by identification of the actual bleeding point and treated with chemical or electrocautery, bipolar diathermy or small packs placed directly over the bleeding point. Secondary epistaxis should be managed by identification of the cause, with application of appropriate nasal therapy and, importantly, corrective systemic medical management. We now have useful guidelines for the management of patients whose epistaxis is secondary to warfarin and a growing body of information regarding complementary medicines that may contribute to bleeding. The literature continues to support the role of antiplatelet drugs as important risk factors for epistaxis. Patients with continued epistaxis despite initial measures should be considered earlier, rather than later, for surgical ligation techniques or embolization. Children with epistaxis should be managed with topical antiseptic cream with or without septal cautery. Recent literature focuses on the cause and management of epistaxis. Although the level of evidence available for this topic is low, there have been many clinically useful studies that will contribute to an overall improvement in patient care.

Acute Disseminated Erythematous Papulovesicular Skin Lesions in a 7-year-old Child: A Quiz

A 7-year-old girl presented with moderately pruritic cutaneous lesions that had developed suddenly a week previously and that were accompanied by subfebrility in the evenings (Fig. 1). In addition, tense blisters were found on the hands and feet, including the palms and soles. The face and mucous membranes were not affected. The patient had not suffered from previous illness, atopy or infections and had not received any recent vaccinations. A physical examination revealed no other pathological findings. Laboratory tests, including a blood cell count and measurement of serum C-reactive protein levels, revealed no abnormalities. Bullous autoimmune dermatoses were excluded by the results of direct and indirect immunofluorescence analyses. A punch biopsy of the leg was performed. The epidermis displayed focal acanthosis with spongiosis and pseudoPautrier abscesses. A moderate superficial perivascular infiltrate of lymphocytes and small numbers of eosinophils was also present. Oral corticosteroid (methylprednisolone; initial dose 32 mg/day – subsequently reduced) and an oral antihistamine were administered, and an antiseptic cream (triclosan 2%) was applied topically. The skin lesions subsided within a week without relapse.

Comparison on different venous catheter settings in hemodialysis patients

Objective To study jugular vein, subclavian vein and femoral vein catheterizations in terms of indwelling time and complications, and sum up experience and lessons of dialysis vein catheterizations. Metbods 190 cases of central venous catheterization from December 2007 to March 2010 in our hemodialysis center were observed retrospectively. The three methods of catheterizations were compared in operation complications, indwelling time,catheter dysfunction, local venous obstruction, infection,catheter disengage and other late complications. Results The success rates of the three methods were similar, jugular vein catheters had less complications and the longest indwelling time, and provided superior blood flow .But jugular vein catheters showed higher incidence of exit site infection and sepsis. Dressing catheter exit sites with dry gauze and antiseptic ointments was good effective to treat exit site infection.Conclusion The internal jugular vein catheterization is a better temporary vascular access for hemodialysis.But exit site infection and sepsis should be paid attention to during the progress. Key words: Venous catheterization; Hemodialysis; Complication

A double-blind randomized controlled trial of management of recurrent nosebleeds in children

Background To establish whether a treatment regimen of silver nitrate cautery and 4 weeks of antiseptic nasal cream is superior to antiseptic cream treatment alone in the management of pediatric epistaxis. Study Design Double-blind randomized controlled trial. Subjects and Methods Children with epistaxis and visible anterior septal vessels were invited to participate. Patients were randomized to receive treatment or control. Treatment patients received silver nitrate cautery, followed by antiseptic cream for 4 weeks. Control patients received sham cautery followed by antiseptic cream for 4 weeks. Results A total of 109 patients were randomized and results were available for 93 (85%). Of those receiving cautery, 21 (45.7%) of 46 had no bleeding in the 4 weeks before follow-up. Of those receiving only antiseptic cream 14 (29.8%) of 47 had no bleeding. (χ 2 = 2.49; P = 0.114). More children in the active treatment group had an improvement in their symptoms compared with controls (42 of 46; 91.3%) in the treatment group vs 33 of 47 (70.2%) controls (χ 2 = 6.626; P = 0.01; relative risk reduction = 71 percent, number needed to treat = 4.7). Conclusion When using subjective improvement in symptoms as the outcome measure, silver nitrate cautery with antiseptic cream twice daily for 4 weeks appears to give a small but statistically significant benefit when compared to antiseptic cream alone.

Health implications of mercury exposure in children

Mercury is a ubiquitous environmental toxin that can produce a wide range of health effects in humans. It is found in three chemical forms: organic, inorganic and elemental (mercury). The sources of exposure are also markedly different for the different forms of mercury. Diet, especially fish and other seafood, is the main source of exposure of the general public to organic mercury. Dental amalgam is the most important source for elemental mercury vapour in the general population. Inorganic mercury compounds are known as 'mercuric salts', which are sometimes used in skin-lightening creams and as antiseptic creams and ointments. Though its use has been banned in some countries, these products are still available on the world market. Each mercury form possesses a different risk to human health. Mercury can be transferred prenatally to the developing foetus via the placenta or postnatally from breast milk to the nursing infant. Children are potentially more susceptible to mercury than adults due to differences in the stages of brain development and organ growth that occur during the foetal, infant and childhood developmental periods. The objective of this paper is to review the relevant literature concerning transplacental and lactational exposure to mercury, taking into account mercury speciation, in order to have a critical assessment of its adverse health effects. Attention is also given to available studies in Saudi Arabia where skin-lightening creams, dental amalgam and thimerosal are still in use.

Long-term effectiveness of antiseptic cream for recurrent epistaxis in childhood: Five-year follow up of a randomised, controlled trial

Long-term effectiveness of antiseptic cream for recurrent epistaxis in childhood: Five-year follow up of a randomised, controlled trial

Perianal Streptococcal Dermatitis: An Important Differential Diagnosis in Pediatric Patients

Perianal streptococcal dermatitis is an infectious disease that predominantly affects younger children and is mostly caused by Group A beta-hemolytic streptococci. Although patients are mostly seen primarily by their pediatrician or family physician, the diagnosis is not infrequently established just after referral to a dermatologist or colorectal surgeon. We report a case series of 124 children, aged 14 years or younger, who were seen at our office for anorectal complaints between February 2003 and September 2006. Twenty-one of 124 patients (16 percent) were diagnosed with perianal streptococcal dermatitis on the basis of a positive perianal swab by microbiologic analysis. Perianal streptococcal dermatitis was the most frequent infectious disease in that age group in our practice. Sixteen (of 21, 76 percent) patients were male, and the mean age was 6.3 years. One course of systemic antibiotic treatment augmented by additional local antiseptic ointment in selected cases cured all patients within 10 to 14 days. One patient presented with a new perianal streptococcal dermatitis episode five months after treatment and was successfully retreated with an oral antibiotic. With this report, we wish to alert the colorectal community of the diagnosis because it may be underdiagnosed in our practices and thereby lead to prolonged discomfort, protracted disease, and potentially harmful sequelae for these typically very young patients.

Long-term effectiveness of antiseptic cream for recurrent epistaxis in childhood: five-year follow up of a randomised, controlled trial

To determine the long-term outcome for children treated for recurrent epistaxis, and to compare the efficacy of antiseptic cream treatment and nasal cautery. Retrospective analytical cohort study of 88 children treated for recurrent epistaxis in 2001. Five-year data on chlorhexidine-neomycin cream usage, nasal cautery, current epistaxis frequency and emergency room attendance was collected by telephone interview and case record review. During their first clinic visit, 51 per cent of the children had been treated with cautery and cream and 35 per cent with cream alone; 14 per cent had received no treatment. Five years later, 65 per cent of these children were still having ongoing epistaxis. Those who had undergone cautery and received cream had the highest ongoing bleeding rate (77 per cent). The majority of children treated at our clinic for recurrent epistaxis had ongoing bleeding five years later. Despite the proven short-term efficacy of chlorhexidine-neomycin cream, few patients receive further courses of cream or are referred back to the clinic.

A Review of Thimerosal (Merthiolate) and its Ethylmercury Breakdown Product: Specific Historical Considerations Regarding Safety and Effectiveness

Thimerosal (Merthiolate) is an ethylmercury-containing pharmaceutical compound that is 49.55% mercury and that was developed in 1927. Thimerosal has been marketed as an antimicrobial agent in a range of products, including topical antiseptic solutions and antiseptic ointments for treating cuts, nasal sprays, eye solutions, vaginal spermicides, diaper rash treatments, and perhaps most importantly as a preservative in vaccines and other injectable biological products, including Rho(D)-immune globulin preparations, despite evidence, dating to the early 1930s, indicating Thimerosal to be potentially hazardous to humans and ineffective as an antimicrobial agent. Despite this, Thimerosal was not scrutinized as part of U.S. pharmaceutical products until the 1980s, when the U.S. Food and Drug Administration finally recognized its demonstrated ineffectiveness and toxicity in topical pharmaceutical products, and began to eliminate it from these. Ironically, while Thimerosal was being eliminated from topicals, it was becoming more and more ubiquitous in the recommended immunization schedule for infants and pregnant women. Furthermore, Thimerosal continues to be administered, as part of mandated immunizations and other pharmaceutical products, in the United States and globally. The ubiquitous and largely unchecked place of Thimerosal in pharmaceuticals, therefore, represents a medical crisis.

The long‐term effectiveness of antiseptic cream for recurrent epistaxis in childhood ‐ 5 year follow‐up of a randomized controlled trial

The long‐term effectiveness of antiseptic cream for recurrent epistaxis in childhood ‐ 5 year follow‐up of a randomized controlled trial

Re: Letter Submission “Antiseptic Obstetric Cream for Pelvic Examination: Where is the Evidence?”

Dear Editors, In the course of a pelvic examination, the examiner requires the use of a lubricant to ensure the comfort of the patient. This issue is of particular importance when caring for a woman in delivery, when the number of examinations can range from one to many, depending on the course of the labor. The Israeli Ministry of Health in its directives for “Cleaning and Disinfection in Hospitals,” recommends the use of obstetric cream containing 1% Chlorhexidene as a lubricant for pelvic examinations in gynecological clinical practice (Ministry of Health 2001). We searched the literature on the subject and could find no evidence supporting this guideline. A number of articles addressed the use of Chlorhexidene at a concentration of 0.25% either as treatment for chlamydial infections (in animal studies) or to reduce the risk of vertical HIV transmission during labor (Patton et al. 1998; Rabe & Hillier 2000; South African Department of Health 2000). Midwives working in our hospital have reported that a number of women in labor complain of sensitivity to the antiseptic obstetric cream, expressed as a burning sensation and edema of the area later. As a result, many of the midwives use paraffin oil, ultrasound gel, or even tap water as a lubricant for pelvic examinations. It is well known and supported by literature that pelvic examinations during labor are a risk factor for postpartum infections (Hawrylyshyn et al. 1981; Roongpisuthipong

Direct Analysis of Pharmaceutical Drug Formulations Using Ion Mobility Spectrometry/Quadrupole-Time-of-Flight Mass Spectrometry Combined with Desorption Electrospray Ionization

A novel approach to the rapid analysis of pharmaceutical drug formulations using hyphenated ion mobility spectrometry (IMS) and time-of-flight mass spectrometry (ToF-MS) that requires no sample pretreatment or chromatographic separation is described. A modified quadrupole time-of-flight mass spectrometer containing an ion mobility drift cell was used for gas-phase electrophoretic separation of ions prior to ToF-MS detection. The generation of sample ions directly from tablets and cream formulations was effected by desorption electrospray ionization (DESI) using a modified electrospray ion source. The analysis of a range of over-the-counter and prescription tablet formulations is described, including histamine H2 receptor antagonist (ranitidine), analgesic (paracetamol), opiate (codeine), and aromatase inhibitor anticancer (anastrozole) drugs. The successful determination of active drugs from soft formulations, such as an antiseptic cream (chlorhexidine) and a nicotine-containing skin patch, is also presented. Limits of detection for the active drugs using the DESI/IMS/ToF-MS method fell within the high-picomole to nanomole range. In all cases, the use of ion mobility drift tube separation showed increased selectivity for active drug responses (present as low as 0.14% w/w) over excipient responses such as poly(ethylene glycol). Tandem mass spectrometric analysis of precursor ions separated by IMS allowed positive confirmation of active drugs with little loss of ion mobility efficiency. The ability to analyze hard or soft pharmaceutical formulations directly by DESI combined with ion mobility spectrometry/mass spectrometry in approximately 2 min demonstrates the potential applicability of this novel method to pharmaceutical screening of low-molecular-weight drug formulations with high selectivity over the formulation vehicle.