Octenidine Research Articles

Antimicrobial nanofibrous mats with controllable drug release produced from hydrophobized hyaluronan

Due to their large active surface, high loading efficiency, and tunable dissolution profiles, nanofibrous mats are often cited as promising drug carriers or antimicrobial membranes. Hyaluronic acid has outstanding biocompatibility, but it is hydrophilic. Nanofibrous structures made from hyaluronan dissolve immediately, making them unsuitable for controlled drug release and longer applications. We aimed to prepare a hyaluronan-based antimicrobial nanofibrous material, which would retain its integrity in aqueous environments. Self-supporting nanofibrous mats containing octenidine dihydrochloride or triclosan were produced by electrospinning from hydrophobized hyaluronan modified with a symmetric lauric acid anhydride. The nanofibrous mats required no cross-linking to be stable in PBS for 7 days. The encapsulation efficiency of antiseptics was nearly 100%. Minimal release of octenidine was observed, while up to 30% of triclosan was gradually released in 72 h. The nanofibrous materials exhibited antimicrobial activity, the fibroblast viability was directly dependent on the antiseptic content and its release.

Antimicrobial Efficacy of Octenidine Dihydrochloride and Artemisia Annua Plant Extract as Root Canal Irrigants – An In Vivo Study

Objectives: The study aimed to evaluate and compare the antimicrobial efficacy of two root canal irrigantsOctenidine dihydrochloride and herbal Artemisia annua plant extract. Methods: Forty-two maxillary central incisors teeth were selected which were divided into four groups – group A (Octenidine dihydrochloride with saline), group B (only Octenidine dihydrochloride), group C (Artemisia annua with saline), group D (only Artemisia annua). Samples for microbiological culturing were collected after access preparation, after biomechanical preparation, and after final irrigation in each group with the help of paper points. CFU count was observed for both aerobic and anaerobic bacteria. The results were collected and subjected to a Student t-test. Results: After statistical analysis, it was observed that bacterial reduction was seen in all the groups but the maximum reduction was observed in group A. Conclusion: The results of the present study imply that a highly significant reduction in CFU/ml count was found in subgroup A1. Therefore, within the limitations of the present in-vivo study, Octenidine dihydrochloride can be recommended as an effective root canal irrigant than Artemisia annua plant extract.

Photodynamic Therapy for the Treatment of Infected Leg Ulcers-A Pilot Study.

Chronic and infected leg ulcers (LUs) are painful, debilitating, resistant to antibiotics, and immensely reduce a patient’s quality of life. The purpose of our study was to demonstrate the efficacy of photodynamic therapy (PDT) for the treatment of infected chronic LUs. Patients were randomized into two experimental groups: the first group received 5-aminolevulinic acid photodynamic therapy (ALA-PDT) (10 patients), and the second group of 10 patients received local octenidine dihydrochloride (Octenilin gel) exposed to a placebo light source with an inserted filter that mimiced red light. In the PDT group, we used 20% ALA topically applied for 4 hrs and irradiation from a Diomed laser source with a wavelength of 630 nm at a fluency of 80 J/cm2. ALA-PDT was performed 10 times during a 14-day hospitalization in 10 patients of both sexes aged 40–85 years with chronic leg ulcers. Treatments were carried out at 3-week intervals for 3–5 cycles. At 8-month follow-up with the PDT group, complete remission (CR) was obtained in four patients (40%), partial response (>50% reduction in ulcer diameter) in four patients (40%), and no response in two patients (20%) who additionally developed deterioration of the local condition with swelling, erythema, and inflammation. To assess the degree of pain during the trials, we used a numeric rating scale (NRS). From the preliminary results obtained, we concluded that PDT can be used to treat leg ulcers as a minimally invasive and effective method with no serious side effects, although further studies on a larger group of patients with LUs are warranted.

Effects of Octenidine on the Formation and Disruption of Dental Biofilms: An Exploratory In Situ Study in Healthy Subjects

Dental biofilms are highly structured, complex multispecies communities that, if left untreated, lead to severe oral complications such as caries and periodontal diseases. Therefore, antibiofilm agents are often recommended for both preventive and therapeutic measures. However, biofilm management can be challenging due to the low sensitivity of biofilms to antimicrobial treatments. Octenidine dihydrochloride (OCT) is a highly effective antibacterial agent. Because the OCT antibiofilm efficacy has not been studied in situ, this exploratory crossover study aimed to evaluate the effects of OCT mouth rinsing on biofilm formation and on the disruption of mature biofilms. Moreover, a comparison to the gold-standard chlorhexidine (CHX) was conducted. The biofilms were formed intraorally by 5 healthy volunteers on enamel specimens fixed to acrylic splints. For biofilm formation analysis, OCT, CHX, or water rinses were applied for 30 s every 12 h. The samples evaluation took place at 24-and 48-h time points. For biofilm disruption analysis, sample assessment was performed before and directly after the first OCT or CHX rinse on 48-h mature biofilms. A second rinse was carried out 12 h later. The last assessment was applied to 72-h mature biofilms. The biofilms were analyzed by fluorescence microscopy and transmission electron microscopy. The results showed OCT significantly reducing biofilm formation and bacterial vitality in situ. Simultaneously, the biofilm thickness was strongly decreased. Moreover, a single application of OCT to a 48-h mature biofilm induced substantial biofilm disruption. In addition, the efficacy of OCT compared favorably to CHX. These findings show that OCT rinses prevent biofilm formation and disrupt preexisting mature biofilms formed by healthy subjects. This work suggests that OCT might be used for dental biofilm management as a part of the medical treatment of oral diseases. Future studies with a larger subject heterogeneity and number are needed to confirm the observed OCT effects.

Efficacy of 0.2% chlorhexidine gluconate and 0.1% octenidine dihydrochloride mouth rinses in patients with plaque induced gingivitis: Double blinded randomised case control study.

Aims: The study aims at making a comparative study of two commercially available mouth rinses, 0.2% chlorhexidine gluconate and 0.1% octenidine dihydrochloride for assessing their efficacy as an antiplaque agent in patient with plaque induced gingivitis.
 Methods and Material:
 In double-blinded experimental study forty-five patients with dental plaque induced gingivitis, divided into 3 groups of 15 patients each, were advised 0.2% chlorhexidine gluconate (CHX) and 0.1% octenidine dihydrochloride (OCT) and distilled water as a mouth rinses respectively. Clinical parameters viz, Plaque Index, Modified Gingival Index and Gingival Bleeding Index were assessed (day 0, 5,10 and15). Microbial count was also assessed from the collected plaque samples (at day 0 and on day 15). Antimicrobial susceptibility test was also done.
 Statistical analysis used: One- way ANOVA with post hoc test using Tukey, Paired- t test, Mann-Whitney U test, The Kruskal-Wallis test, Wilcoxon signed-rank test
 Results:
 There was significant difference in mean plaque index between the different groups. There was a significant reduction in plaque index for 0.2% CHX The mean modified gingival index was higher in group belonging to 0.1% OCT compared to 0.2% CHX that was statistically significant (p = 0.005). Similarly, the mean gingival bleeding index was significantly higher in group belonging to 0.1% OCT compared to 0.2% CHX (p = 0.005). On day 15 change in the microbial count was statistically significant for 0.2% CHX (p = 0.026).and 0.1% OCT (p = 0.001).
 Conclusions:
 The antimicrobial and antiplaque efficacy (in vivo and in vitro) of 0.1% octenidine dihydrochloride containing mouth rinse was comparatively higher than that containing 0.2% chlorhexidine gluconate thereby demonstrating the former's potential usefulness in controlling plaque and gingivitis.

Synthesis and antibacterial activity of new tetrakisquaternary ammonium compounds based on pentaerythritol and 3-hydroxypyridine

Tetrakisquaternary ammonium compounds based on pentaerythritol were synthesized for the first time. Bacteriostatic effect of the obtained compounds was evaluated towards opportunistic gram-positive Methicillin-resistant Staphylococcus aureus (strain ATCC 25923), gram-negative Escherichia coli (ATCC 25922), and Pseudomonas aeruginosa (ATCC 27853). The activity of reported salts was evaluated competitively with that of known antiseptics, Octenidine Dihydrochloride and Chlorhexidine Digluconate. The effect of length of the alkyl substituent in the salts on their biological activity was established. These new compounds are based on available pentaerythritol and 3-hydroxypyridine.

Drug-Silica Coassembled Particles Improve Antimicrobial Properties of Endodontic Sealers

IntroductionThe purpose of this study was to assess the antimicrobial activity and flow of root canal sealers after incorporating novel highly loaded antimicrobial drug-silica coassembled particles (DSPs). MethodsDSPs were synthesized through coassembly of silica and octenidine dihydrochloride (OCT) antimicrobial surfactant. DSPs were loaded (1% and 2% wt) into epoxy resin sealer (AH Plus [AH]; Dentsply DeTrey GmbH, Konstanz, Germany) or calcium silicate–based sealer (EndoSequence Bioceramic Sealer (BC); Brasseler, Savannah, GA). OCT release from DSP-modified sealers was determined using liquid chromatography. Antimicrobial activity of sealers against planktonic or biofilm form Enterococcus faecalis was assessed using direct contact and membrane restricted tests. Sealer flow was tested according to ISO6876:2012. ResultsOCT release from BC + 1% or 2% DSPs was above the minimum inhibitory concentration following 2 days throughout the 30-day experiment, whereas OCT release from AH + 1% or 2% DSP was significantly below the minimum inhibitory concentration against E. faecalis (4 μg/mL) over the whole 30-day experimental period. All materials (with or without DSPs) killed planktonic bacteria initially. AH ± 1% or 2% DSPs had no antimicrobial activity after 7 days. BC + 1% or 2% DSPs maintained antibacterial activity over the 30-day period. Both modified and unmodified sealers completely inhibited the growth of E. faecalis biofilms after 24 hours of contact. DSPs decreased the flow of AH and BC sealers; for AH, the reduction was proportional to the amount of DSPs added. All modified and unmodified sealers, except for AH + 2% DSPs, were within the acceptable limits of ISO 6876 flow tests. ConclusionsDSPs enhanced the antimicrobial performance of BC but not AH, whereas the material’s flow remained compliant with ISO 6876 standards. Depending on the sealer, DSPs may enhance antimicrobial efficacy in root canal treatment and potentially improve treatment outcome.

Comparison of the in-vitro efficacy of different mouthwash solutions targeting SARS-CoV-2 based on the European Standard EN 14476

The outbreak of the SARS-CoV-2 pandemic is triggering a global health emergency alert. Until vaccination becomes available, a bundle of effective preventive measures is desperately needed. Recent research is indicating the relevance of aerosols in the spread of SARS-CoV-2. Thus, in this study commercially available antiseptic mouthwashes based on the active ingredients chlorhexidine digluconate and octenidine dihydrochloride (OCT) were investigated regarding their efficacy against SARS-CoV-2 using the European Standard 14476. Based on the requirement of EN 14476 in which reduction of at least four decimal logarithms (≥4 log10) of viral titre is requested to state efficacy, the OCT-based formulation was found to be effective within a contact time of only 15 s against SARS-CoV-2. Based on this in-vitro data the OCT mouthwash thus constitutes an interesting candidate for future clinical studies to prove its effectiveness in a potential prevention of SARS-CoV-2 transmission by aerosols.

Synergistic Effects of Propolis Combined with 2-Phenoxyethanol and Antipyretics on the Growth of Staphylococcus aureus.

The present investigation aimed to assess the combinational effect of commonly used antipyretics and antiseptics with ethanolic extracts of propolis (EEPs) on the growth inhibition of Staphylococcus aureus. The broth microdilution checkerboard assay revealed synergistic interactions between all investigated antipyretics, namely acetylsalicylic acid, ibuprofen, and acetaminophen, with EEPs samples. The values of the fractional inhibitory concentration (ΣFIC) index for all these combinations were <0.5. While, in the case of considered antiseptics, namely chlorhexidine, octenidine dihydrochloride, and 2-phenoxyethanol, the positive interaction was confirmed only for the last one (values of ΣFIC in the range 0.0625–0.25). Combinations of two other agents with all four samples of EEPs resulted in an important antagonistic effect (values of ΣFIC ≥ 4.5). Propolis is mostly dedicated to the treatment of skin/wound infections; thus, these findings are of particular practical importance. The outcomes of the study also support the hypothesis that the propolis’s antimicrobial effect is due to the combined (synergistic) action of several ingredients rather than the presence of one component of high antibacterial activity. The composition of 13 ingredients of EEPs (at a concentration below the MIC (minimum inhibitory concentration) of the most active agent) exhibited considerably high anti-staphylococcal efficiency with MIC = 128 µg/mL.

Octenidine dihydrochloride treatment of a meticillin-resistant Staphylococcus aureus biofilm-infected mouse wound.

This study sought to estimate the effect of a liquid octenidine dihydrochloride (OCT)-impregnated gauze dressing in the treatment of meticillin-resistant Staphylococcus aureus (MRSA) biofilm-infected wounds. In this animal study, a six-millimetre punch full-thickness wound on each mouse back was inoculated with MRSA suspension, and then covered with a Tegaderm (3M Health Care, US) dressing for an established biofilm model. Animals were divided into three groups for topical application: control group (treated with phosphate-buffered saline, PBS); mupirocin group (treated with 2% mupirocin); and OCT group (treated with OCT). All applications were administrated once 24 hours post-wounding. The bioburden was determined by counting colony-forming units (cfus) and the biofilm architecture was viewed using fluorescent staining and scanning electron microscopy (SEM) on day two. The tissue repair was evaluated histologically and the related genes were detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR) on day 15. The results suggested OCT accelerated healing and reduced by >3.6 log cfu/g bacterial counts on the wounds relative to the PBS-treated control (p<0.05). Histological analysis showed OCT-treated tissue exhibited lower burden of the inflammatory cells, more mature collagen fibres and well-defined epithelialisation. LIVE/DEAD fluorescent staining and SEM confirmed OCT induced a substantial destruction to biofilm structure. RT-qPCR further demonstrated that OCT therapy could inhibit the expression of MRSA and its biofilm genes by nearly 100% (p<0.05). This investigation provides a rare in vivo experimental basis for OCT improvement on MRSA-infected wound healing and the superior efficacy implies OCT topical application may represent an ideal choice to address established bacterial biofilm in hard-to-heal wounds.

Does Cavity Disinfectant Affect Sealing Ability of Universal Self-etch Adhesive?

The purpose of this study was to evaluate 2% chlorhexidine disinfectant (CHX), chitosan, and octenidine dihydrochloride (as cavity disinfectants) on microleakage in cavities restored with universal self-etch adhesive. Eighty extracted human permanent premolars were selected. Class V cavities were prepared on the facial surface of each tooth. The teeth were then divided into four groups of 20 teeth each. For the control group after cavity preparation, no disinfectant was applied. The other 3 groups were treated with 0.1% chitosan, 2% CHX, and 0.1% octenidine dihydrochloride (OCT). All the groups were restored with universal adhesive followed by composite resin. The teeth were then immersed in 1% methylene blue dye and were sectioned buccolingually. Microleakage was checked under a stereomicroscope on both occlusal and gingival margins. Among all the groups chitosan-treated cavities showed the least microleakage. Chlorhexidine treated cavities showed less leakage as compared to control, OCT group at both the margins. Chitosan as a cavity disinfectant improves the sealing ability of the self-etch adhesive. Furthermore, in vivo studies need to be conducted to examine the interaction and long-term effect of chitosan with the other self-etch adhesive systems. Chitosan a natural polysaccharide can be used as a cavity disinfectant as it improves the sealing ability of self-etch adhesive.

Octenidine-based hydrogel shows anti-inflammatory and protease-inhibitory capacities in wounded human skin

Octenidine dihydrochloride (OCT) is a widely used antiseptic molecule, promoting skin wound healing accompanied with improved scar quality after surgical procedures. However, the mechanisms by which OCT is contributing to tissue regeneration are not yet completely clear. In this study, we have used a superficial wound model by tape stripping of ex vivo human skin. Protein profiles of wounded skin biopsies treated with OCT-containing hydrogel and the released secretome were analyzed using liquid chromatography-mass spectrometry (LC–MS) and enzyme-linked immunosorbent assay (ELISA), respectively. Proteomics analysis of OCT-treated skin wounds revealed significant lower levels of key players in tissue remodeling as well as reepithelization after wounding such as pro-inflammatory cytokines (IL-8, IL-6) and matrix-metalloproteinases (MMP1, MMP2, MMP3, MMP9) when compared to controls. In addition, enzymatic activity of several released MMPs into culture supernatants was significantly lower in OCT-treated samples. Our data give insights on the mode of action based on which OCT positively influences wound healing and identified anti-inflammatory and protease-inhibitory activities of OCT.

Evaluation of effectiveness of a mouthwash containing antiseptic octenidine dihydrochloride

Was to assess changes in the oral microbiota when using octenidine dihydrochloride mouthwash. Quantitative and qualitative changes in the oral microbiota were studied and evaluated after a single rinse, course application and long-term dates. A single rinse resulted in a significant decrease in the number of pathogenic microorganisms: S. aureus, C. albicans, and Enterobacteriae. After a seven-day course of mouthwash application, the complete disappearance of pathogenic microorganisms: S. aureus, S. albicans, and Enterobacteriae and an increase in the number of Lactobacillus spp were revealed. 7 days after the mouthwash was canceled, there was some recovery of pathogenic (S. aureus, Candida), the number of Lactobacillus spp. remained the same, normal microflora almost completely restored. Octenidine dihydrochloride mouthwash may be recommended for wide use in dental practice in the treatment of various oral pathological conditions, including candidiasis and dysbiosis.

Comparitive evaluation of antimicrobial efficacy of 0.1% octenidine dihydrochloride, 2% chlorhexidine and 2% chitosan against E.faecalis within the dentinal tubules

Root canal treatment is a type of endodontic therapy used to perform for the elimination of the micro-organisms by standardized mechanical instrumentation and adequate cleaning and shaping of the infected root canal. The readily available root canal irrigants which are used in endodontic therapy have shown somewhat toxic and harmful side effects when used at certain concentration, some of the endodontic irrigants have shown species specific resistance to a particular microbial load that’s why there is a need to discover newer irrigants which are non toxic, effective and can be used safe to use.In vitro evaluation and comparision of the antimicrobial efficacy of 0.1% octenidine dihydrochloride (OCT), of 2% chlorhexidene (CHX) and 2% chitosan as root canal irrigant against E. faecalis within the dentinal tubules at 200µ and 400µm depth.Seventy two freshly extracted mandibular molars were decoronated and the mesial root specimen was standardized till working length. E.faecalis (strain MTCC 439) was grown on brain heart infusion sheep blood agar plate until seven days and the decoronated root specimens collected were divided into four groups (n=18) based on irrigation protocol: Group 1 – 2% chlorhexidene (CHX), Group 2 - 0.1% octenidine dihydrochloride (OCT), Group 3- 2% chitosan and Group 4 – normal saline . Each specimen was irrigated with particular irrigant till 3 minutes. Dentin shavings were obtained from root specimens using diamond disc and these dental chips were used to calculate the colony forming unit at 200µ and 400µm depth. The data obtained after the experiment was statistically analyzed.Non significant difference has been shown by group 1when compared with group 2 while significant difference has been shown by group 3 when compared with group 1 and group 2 by taking into account that group 4 is taken as control group. Significant difference was found when all the groups 1-4 were compared at 200 and 400 µm depth.It was observed and evaluated that antimicrobial efficacy of 2% chitosan against e. faecalis was found to be higher as compred to 2% chlorhexidene (CHX) and 0.1% octenidine dihydrochloride (OCT) both at 200µ and 400µm depth.

Antimicrobial antidegradative dental adhesive preserves restoration-tooth bond

ObjectiveAssess the ability of an antimicrobial drug-releasing resin adhesive, containing octenidine dihydrochloride (OCT)-silica co-assembled particles (DSPs), to enhance the biostability and preserve the interfacial fracture toughness (FT) of composite restorations bonded to dentin. Enzyme-catalyzed degradation compromises the dental restoration-tooth interface, increasing cariogenic bacterial infiltration. In addition to bacterial ingress inhibition, antimicrobial-releasing adhesives may exhibit direct interfacial biodegradation inhibition as an additional benefit. MethodsMini short-rod restoration bonding specimens with total-etch adhesive with/without 10% wt. DSPs were made. Interfacial fracture toughness (FT) was measured as-manufactured or post-incubation in simulated human salivary esterase (SHSE) for up to 6-months. Effect of OCT on SHSE and whole saliva/bacterial enzyme activity was assessed. Release of OCT outside the restoration interface was assessed. ResultsNo deleterious effect of DSPs on initial bonding capacity was observed. Aging specimens in SHSE reduced FT of control but not DSP-adhesive-bonded specimens. OCT inhibited SHSE degradation of adhesive monomer and may inhibit endogenous proteases. OCT inhibited bacterial esterase and collagenase. No endogenous collagen breakdown was detected in the present study. OCT increased human saliva degradative esterase activity below its minimum inhibitory concentration towards S. mutans (MIC), but inhibited degradation above MIC. OCT release outside restoration margins was below detection. SignificanceDSP-adhesive preserves the restoration bond through a secondary enzyme-inhibitory effect of released OCT, which is virtually confined to the restoration interface microgap. Enzyme activity modulation may produce a positive-to-negative feedback switch, by increasing OCT concentration via biodegradation-triggered release to an effective dose, then subsequently slowing degradation and degradation-triggered release.

Octenidine: Novel insights into the detailed killing mechanism of Gram-negative bacteria at a cellular and molecular level

Octenidine (OCT) is a widely used antiseptic molecule with an antimicrobial spectrum covering a broad range of bacteria and fungi. However, the detailed molecular mechanism of killing has not yet been elucidated. The objective of our study was to investigate the mode of action of OCT's potent effect on Gram-negative bacteria using Escherichia coli as a model organism as well as corresponding model membranes. The effects of OCT on cellular morphology were observed by electron microscopy, changes affecting membrane integrity (surface charge, fluidity, permeabilisation and depolarisation) by zeta potential, fluorescence microscopy and spectroscopy. Specific interactions of OCT with membrane phospholipids were addressed using differential scanning calorimetry, X-ray scattering and fluorescence techniques. OCT neutralises the surface charge of E. coli leading to disruption of the outer membrane and dramatic loss of the cell wall and further penetrates through the periplasmic space reaching the inner membrane. Model membranes showed that OCT inserts into the hydrophobic fatty acyl chain region of the bilayer, inducing complete lipid disorder. The loss of membrane integrity is also reflected by membrane depolarisation and changes in membrane fluidity as shown by electron microscopy. Insertion of OCT into the outer and inner membrane of E. coli results in a chaotic lipid arrangement that leads to rapid disruption of the cell envelope. We propose that this unspecific mode of action based on purely physical interactions is the basis of the very broad antimicrobial profile and makes it unlikely that resistance to OCT will develop.

Octenidine/carbenicillin GUMBOS as potential treatment for oropharyngeal gonorrhoea.

Reducing Neisseria gonorrhoeae colonies in the oropharynx is a viable solution to minimize the transmission of this bacterium amongst individuals. A strategy involving the electrostatic interaction between a common antiseptic and a discontinued antibiotic (i.e. octenidine and carbenicillin) was evaluated as a potential treatment for gonorrhoea. Octenidine/carbenicillin is a novel group of uniform materials based on organic salts (GUMBOS) with inherent in vitro antibacterial activity that comes from its parent antiseptic and antibacterial ions, octenidine and carbenicillin, respectively. Antibacterial activities for octenidine dihydrochloride, disodium carbenicillin, octenidine/carbenicillin and stoichiometrically equivalent 1:1 octenidine dihydrochloride to disodium carbenicillin were assessed using the Kirby-Bauer disc diffusion assay for N. gonorrhoeae (ATCC 49226) and three clinical isolates. Predictive permeability using the Parallel Artificial Membrane Permeability Assay and cytotoxicity against HeLa cells was also evaluated. Additive in vitro antibacterial activities against N. gonorrhoeae were observed in this study, which suggests octenidine/carbenicillin could be a useful agent in reducing N. gonorrhoeae transmission and minimizing gonorrhoea infections. Octenidine/carbenicillin also exhibited bioequivalence to azithromycin and doxycycline, two currently prescribed antibiotics. Likewise, octenidine/carbenicillin had improved predicted permeability compared with octenidine dihydrochloride. Antimicrobial GUMBOS synthesized in this study could be used as an adjunctive treatment approach to current drug therapies for oropharyngeal gonorrhoea infection control and prevention.

Comparative Evaluation of the Antimicrobial Efficacy of Octenidine Dihydrochloride with Contemporary Root Canal Disinfectants: A Systematic Review

Octenidine is a cationic disinfectant that has been tested for its wide range of antibacterial efficacy and biocompatibility. It finds its application in the medical field as an antiseptic for wounds and mucous membranes. The present systematic review aims to compare the antimicrobial efficacy of Octenidine Dihydrochloride with various root canal irrigants and medicaments. An electronic search strategy was planned to search the database of PUBMED CENTRAL and MEDLINE using the search terms alone and in combination using PUBMED search builder till September 2019 for related studies. In Vitro studies that compared the antibacterial efficacy of Octenidine Dihydrochloride to other irrigants and medicaments against Enterococcus faecalis and Candida albicans using extracted human teeth were included in the review. The primary outcome measure was the reduction in the microbial load which was assessed through either CFU or the percentage of viable and dead bacteria. A total of 7 studies that matched the inclusion criteria were included in the systematic review. The studies indicated that Octenidine Dihydrochloride was highly effective in eliminating E faecalis and C albicans and could be a more biocompatible potential alternative or an adjunct to the existing irrigants and medicaments.

Anti-Acanthamoeba disinfection: hands, surfaces and wounds

Acanthamoebae are facultative parasites causing rare but serious infections such as keratitis and encephalitis and are also known as vectors for several bacterial pathogens, including legionellae and pseudomonads. Acanthamoeba cysts are particularly resilient and enable the amoebae to withstand desiccation and to resist disinfection and therapy. While the search for new therapeutic options has been intensified in the past years, hand and surface disinfectants as well as topical antiseptics for preventing infections have not been studied in detail to date. The aim of this study was to screen well-known and commonly used antimicrobial products in various formulations and different concentrations for their efficacy against Acanthamoeba trophozoites and cysts, including aliphatic alcohols, quaternary ammonium compounds (QACs), peracetic acid (PAA), potassium peroxymonosulfate sulfate (PPMS) and octenidine dihydrochloride (OCT). Of all products tested, OCT and QACs showed the highest efficacy, totally eradicating both trophozoites and cysts within 1 min. The determined 50% effective concentration (EC50) for cysts was 0.196 mg/mL for OCT and 0.119 mg/mL for QACs after 1 min of exposure. PAA and PPMS showed reliable cysticidal efficacies only with prolonged incubation times of 30 min and 60 min, respectively. Aliphatic alcohols generally had limited efficacy, and only against trophozoites. In conclusion, OCT and QACs are potent actives against Acanthamoeba trophozoites and cysts at concentrations used in commercially available products, within contact times suitable for surface and hand disinfection as well as topical antisepsis.

Impact of formulary interventions on the minimum inhibitory concentration of methicillin-resistant Staphylococcus aureus to mupirocin, chlorhexidine, and octenidine in a Singapore tertiary institution.

Methicillin-resistant Staphylococcus aureus (MRSA) decolonization is an effective measure to prevent clinical infection but resistance is a concern. We aim to evaluate the impact of mupirocin (MUP) ointment formulary removal, plateauing use of chlorhexidine gluconate (CHG), and hospital-wide introduction of octenidine (OCT)-based products on the minimum inhibitory concentration (MIC) of MRSA to MUP, CHG, and OCT in our hospital. A prevalence study was conducted at three time points (TP) on consecutive MRSA screening isolates to evaluate for their MICs to MUP, CHG, and OCT using broth microdilution sensititre plates and detection of the ileS-2 gene encoding high-level MUP resistance in 2013 (pre-intervention TP1; n = 160), 2016 (early post-intervention TP2; n = 99) and 2017 (late post-intervention TP3; n = 76). Statistical analyses were performed using Chi square test with reference from TP1. There was a significant improvement in MUP susceptibility (MIC < 4 mcg/ml) from 71.9% (TP1) to 86.9% (TP2; p = 0.006) to 88.2% (TP3; p = 0.007). The prevalence of MUP high-level resistance (MIC > 256 mcg/ml) reduced from 25.0% (TP1) to 12.1% (TP2; p = 0.014) to 5.3% (TP3; p = 0.001). Likewise, the prevalence of isolates harboring the ileS-2 gene decreased from 28.1% (TP1) to 18.2% (TP2; p = 0.072) to 9.2% (TP3; p = 0.002). OCT MIC range remains stable at 0.5 to 1 mcg/ml across all three TPs. The proportion of isolates with reduced CHG susceptibility (MIC ≥ 4 mcg/ml) increased over the three TPs from 23.1 to 27.2% (p = 0.45) to 42.1% (p = 0.003). Active formulary regulations have an impact on the resistance profile of MRSA and can be used as a strategy to preserve the MRSA decolonization armamentarium.