Use Of Topical Antiseptics Research Articles

Nurses' and Nursing students' perceptions of their knowledge and satisfaction in managing wound infections: A cross-sectional study.

Nurses' and Nursing students' perceptions of their knowledge and satisfaction in managing wound infections: A cross-sectional study.

Evaluation of the Antimicrobial Efficacy of Novel Antiseptic Nasal Swab Applied to Subject's Nares Colonized with Staphylococcus Aureus

Evaluation of the Antimicrobial Efficacy of Novel Antiseptic Nasal Swab Applied to Subject's Nares Colonized with Staphylococcus Aureus

Exposure to hand sanitisers and other cleaning products in Victoria, Australia during the COVID-19 pandemic

Background In response to the COVID-19 pandemic, there was increased promotion and use of topical antiseptics (especially hand sanitisers) and cleaning products to reduce transmission of the SARS-CoV-2 virus. This study describes unintentional exposures (oral or ocular) to these substances by children during the first year (2020) of the COVID-19 pandemic compared to the previous year (2019). Methods This was a retrospective observational study of unintentional exposures reported to the Victorian Poisons Information Centre for the period 1 January 2019 to 31 December 2020. Substances included topical antiseptics (including hand sanitisers), bleach, multipurpose cleaners, disinfectants and high-percentage ethanol products. We analysed data for two age groups; under 5 years and 5 to 14 years. Results Oral exposures (ingestion or buccal) to topical antiseptics increased from 435 in 2019 to 882 in 2020 in the under 5 age group, with peak call numbers in 2020 coinciding with peaks in active COVID-19 daily case numbers. Oral exposures in older children (5–14 years) were lower (23 and 77 in 2019 and 2020, respectively). No children had moderate or severe symptoms at the time of the call to the Poisons Centre. Ocular exposures to topical antiseptics more than doubled from 2019 to 2020 (from 20 to 53 among children under 5 years, and 8 to 18 in older children). The majority of children with ocular exposure presented with mild symptoms; one had moderate symptoms. Changes in exposures to disinfectants, bleach and cleaners were smaller and not consistent with peaks in active COVID-19 cases. Conclusions Unintentional oral exposures to topical disinfectants (mainly hand sanitiser) by young children increased during the COVID-19 pandemic and were more prevalent during periods of increased COVID-19 cases. While there were no cases of severe harm identified, the high number of exposures suggests that appropriate use and storage of hand sanitisers should be promoted.

Parasites causing cutaneous wounds: Theory and practice from a dermatological point of view

Parasites causing cutaneous wounds: Theory and practice from a dermatological point of view

Применение топических антисептических средств при остром тонзиллофарингите: оценка современных тенденций лечения и профилактики осложнений

Применение топических антисептических средств при остром тонзиллофарингите: оценка современных тенденций лечения и профилактики осложнений

Undesirable Effects of Some Topical Antiseptics Chemical, pharmacological and dermatological aspects

Topical antiseptics are a diverse group of agents that are widely used in medicine for the antimicrobial properties. Despite their long history and broad application, caution must be exercised in their use, especially in the pediatric age group, as various cutaneous reactions ranging from hypersensitivity to urticarial to skin necrosis have been reported. The use of topical antiseptics in pediatrics has also been associated with systemic reactions, which depend on the antiseptic in question. Antiseptics such as chlorhexidine, povidon iodine, methylene blue, gentian violet, silver nitrate, boric acid, Castellani solution, alcohol and chloramines have been reviewed. It is essential that physicians bear in mind the possible adverse effects that may follow topical antiseptic use, as this facilitates prevention and also timely intervention if, and when, they occur.

Umbilical cord separation time: chlorhexidine vs methylated-spirit

Background Use of topical antiseptics could reduce the incidence of infection; however, studies have suggested that some antiseptics prolong the time for cord separation when compared with others. Aims To compare the umbilical cord separation time between neonates receiving 7.1% chlorhexidine gel and methylated spirit. Methods A quasi-experimental research design was employed for this study. A multistage sampling technique was used to select three primary health centers in Ibadan, Nigeria. A total of 212 newborns (118 newborns in the chlorhexidine group and 94 in the methylated spirit group) were enrolled into the study. Findings There was a statistically significant difference in mean time to cord separation between chlorhexidine (9.53 ± 4.559 days) and methylated-spirit group (7.98 ± 2.984) (t=2.840; P=0.005). Conclusions Chlorhexidine gel prolongs cord separation when compared to methylated spirit. Prolonged cord separation time was the major cause of dissatisfaction in the two study groups. The increased cord separation time associated with chlorhexidine should not eliminate it in settings where the risk of cord infection is high, but mothers should be informed of this.

1213. Evaluation of an Alcohol-Based Antiseptic for Nasal Decolonization of Methicillin-Resistant Staphylococcus aureus (MRSA)

BackgroundDue to concerns for emergence of mupirocin resistance, there is an interest in use of topical antiseptics for nasal decolonization of Staphylococcus aureus. Alcohol-based nasal antiseptics have recently been developed as an alternative to mupirocin, but there is limited data on efficacy, particularly among patients where the burden of carriage is often high.MethodsWe evaluated the effectiveness of a one-time application of a commercial alcohol-based nasal sanitizer for reduction in nasal methicillin-resistant Staphylococcus aureus (MRSA) in MRSA-colonized patients. Patients received either a single dose or triple dose over 3 minutes; the triple dose is recommended for preoperative dosing. Swabs were used for quantitative culture of MRSA from the anterior nares and vestibule prior to and 10 minutes, 2 hours, and 6 hours after application. For a subset of patients, cultures for MRSA were collected from hands, clothing, groin, and chest/axilla.ResultsOf 34 MRSA carriers enrolled, 27 (79%) had MRSA detected in nares, 32 (94%) were male, and the mean age was 65. Of the 27 carriers positive for nasal MRSA, 15 (56%) received a single alcohol dose and 12 (44%) received a triple dose over 3 minutes. As shown in the figure, the single and triple dose applications significantly reduced MRSA concentrations at 2 hours post-treatment when the initial burden was low (i.e., <2 log10colonies per swab), but there was no significant reduction at 6 hours; there was no significant reduction with either dose when the initial burden was high (≥2 log10colonies per swab).ConclusionA single application of an alcohol nasal sanitizer significantly reduced nasal MRSA at 2 hours post-application when the initial burden of colonization was low, but not when a high burden of carriage was present. Additional studies are needed to determine whether higher alcohol doses or repeated applications might result in improved efficacy. Figure. Efficacy of one-time application of a single- or triple-dose of alcohol-based nasal sanitizer on the burden of nasal MRSA.Disclosures All authors: No reported disclosures.

Incidence of umbilical cord infection in neonates receiving 7.1% chlorhexidine gel and methylated-spirit in ibadan

Incidence of umbilical cord infection in neonates receiving 7.1% chlorhexidine gel and methylated-spirit in ibadan

The Effect of Antiseptics in the Prophylaxis of Infection in Orthopaedic Surgery.

Over the past decade, the incidence of revision arthroplasty has increased substantially. One of the main reasons for revision arthroplasty is periprosthetic joint infection, often resulting in multiple surgical interventions with variable success and poor clinical outcome. Intraoperative wound irrigation has been proposed to reduce bacterial contamination and thus the risk of periprosthetic infection. However, there is currently no widely accepted recommendation for the use of topical antiseptics within the operative setting for primary implantation. We performed a systematic review of studies pertaining to the use of intraoperative topical antiseptics and their effectiveness in preventing infection of orthopaedic implants. A comprehensive literature search including MEDLINE (PubMed), Cochrane Library, and Current Contents Medicine (CCMED-Medpilot) was performed according to a standardised protocol. Overall, 1905 articles were initially assessed. Four studies met the inclusion criteria and remained for further analysis, comprising two prospective cohort studies using retrospective control groups (evidence level II - III) and two randomised controlled trials (evidence level I). 0.35% Povidone-iodine (PVP-I) was used in three of these studies and a solution of 6.25% PVP-I and 6.25%-hydrogen peroxide (H2O2) in one study for intraoperative wound irrigation. There was a clear trend in all studies suggesting that intraoperative topical antiseptics are effective in preventing periprosthetic infection. Although no clear regimen can be recommended, the available literature indicates that the use of intraoperative topical antiseptics is of clinical relevance in preventing infection of orthopaedic implants. Further randomised controlled trials are recommended.

The Role of Topical Antiseptic Agents Within Antimicrobial Stewardship Strategies for Prevention and Treatment of Surgical Site and Chronic Open Wound Infection.

Scope and Significance: The topical use of antiseptics for wound care has a role in an antimicrobial stewardship strategy. However, the details of this role need clarification. Further clinical research into the use of topical antiseptics in wound care would lower the risk of furthering antibiotic resistance and contribute to more effective antibiotic use. As part of this research, experimental and surveillance data are needed on the resistance and tolerance patterns associated with topical antiseptic use in wound infections. Objective: The development of antibiotic resistance presents global challenges in terms of patient harm and increased healthcare costs. The treatment of "at risk" and infected wounds contributes to this conundrum. Synergies between antibiotics and antiseptics and their appropriate combined use need exploration. Approach: A review of available evidence on the appropriateness of antiseptics as a fundamental component of antimicrobial stewardship strategies has been undertaken. Innovation: Opening up new ways of thinking and identifying gaps of knowledge will lead to optimizing justification of antimicrobial choices and combinations. This may lead to changes in practice in terms of solutions for the prevention and treatment of wound infection. Conclusion: Antiseptics are an integral part of antimicrobial stewardship strategies for the prevention and treatment of surgical site and chronic open wound infections.

COMPLICATIONS AFTER EXTRACTION OF IMPACTED THIRD MOLARS - LITERATURE REVIEW

Third molar surgery is the most common procedure performed by oral and maxillofacial surgeons worldwide. This article addresses the incidence of specific complications and, where possible, offers a preventive or management strategy. Complications, such as pain, dry socket, swelling, paresthesia of the lingual or inferior alveolar nerve, bleeding, and infection are most common. Factors thought to influence the incidence of complications after third molar removal include age, gender, medical history, oral contraceptives, presence of pericoronitis, poor oral hygiene, smoking, type of impaction, relationship of third molar to the inferior alveolar nerve, surgical time, surgical technique, surgeon experience, use of perioperative antibiotics, use of topical antiseptics, use of intra-socket medications, and anaesthetic technique. For the general dental practitioner, as well as the oral and maxillofacial surgeon, it is important to be familiar with all the possible complications after this procedure. This improves patient education and leads to prevention, early recognition and management.

Antibiotic prescribing in wound care

There is uncertainty on antibiotic prescribing in wound infection ( Gürgen, 2012 ); this article, therefore, is aimed at nurse prescribers caring for patients with wounds in primary care, and presents up-to-date evidence-based recommendations on managing infection, and appropriate antibiotic prescribing in chronic and acute wounds. In addition, the use of topical antiseptics and antimicrobial wound dressings, which can be used as an adjunct strategy in managing wound infection, will be discussed.

Pseudomonas aeruginosa wound infections: a critical appraisal of topical antiseptics

Background: Pseudomonas aeruginosa infection is a serious complication of burns and wounds with a high degree of morbidity and mortality. This paper reviews the literature on the use of topical antiseptics for the treatment of P. aeruginosa wound infections. Methods: Embase and PubMed were searched, yielding 119 results that were reviewed. Inclusion criteria were all papers that assessed patients with confirmed P. aeruginosa wound infection treated with topical antiseptics and reported the eradication of the pathogen. Results: Three papers met the inclusion criteria, with a total sample size of 33. All of the studies analyzed acetic acid for the treatment of P. aeruginosa wound infection. The pooled data demonstrated that 84.8% of confirmed P. aeruginosa wound infections were effectively treated with acetic acid. Conclusions: P. aeruginosa remains a serious infection complicating burn and wound healing. Treatment commonly includes topical antiseptics; however, there is a paucity of clinical based trials to support this. Three small trials demonstrated some evidence for the use of acetic acid as a topical treatment. More evidence is required to demonstrate the efficacy of topical antiseptics as well as recommend specific types of topical treatment for this pathogen.

The development, implementation and evaluation of a cross organisational clinical guideline for the management and prevention of wound infection

The development, implementation and evaluation of a cross organisational clinical guideline for the management and prevention of wound infection

Quantifying Type-Specific Reproduction Numbers for Nosocomial Pathogens: Evidence for Heightened Transmission of an Asian Sequence Type 239 MRSA Clone

An important determinant of a pathogen's success is the rate at which it is transmitted from infected to susceptible hosts. Although there are anecdotal reports that methicillin-resistant Staphylococcus aureus (MRSA) clones vary in their transmissibility in hospital settings, attempts to quantify such variation are lacking for common subtypes, as are methods for addressing this question using routinely-collected MRSA screening data in endemic settings. Here we present a method to quantify the time-varying transmissibility of different subtypes of common bacterial nosocomial pathogens using routine surveillance data. The method adapts approaches for estimating reproduction numbers based on the probabilistic reconstruction of epidemic trees, but uses relative hazards rather than serial intervals to assign probabilities to different sources for observed transmission events. The method is applied to data collected as part of a retrospective observational study of a concurrent MRSA outbreak in the United Kingdom with dominant endemic MRSA clones (ST22 and ST36) and an Asian ST239 MRSA strain (ST239-TW) in two linked adult intensive care units, and compared with an approach based on a fully parametric transmission model. The results provide support for the hypothesis that the clones responded differently to an infection control measure based on the use of topical antiseptics, which was more effective at reducing transmission of endemic clones. They also suggest that in one of the two ICUs patients colonized or infected with the ST239-TW MRSA clone had consistently higher risks of transmitting MRSA to patients free of MRSA. These findings represent some of the first quantitative evidence of enhanced transmissibility of a pandemic MRSA lineage, and highlight the potential value of tailoring hospital infection control measures to specific pathogen subtypes.

Topical antiseptics in wound care: time for reflection

Topical antiseptics in wound care: time for reflection

Antimicrobial Activity of Clinically Used Antiseptics and Wound Irrigating Agents in Combination with Wound Dressings

A primary strategy for preventing and treating wound infection in chronic wounds is the use of topical antiseptics and wound irrigating agents. However, their interaction with commonly used wound dressings has not yet been investigated. In this study, the authors analyzed the antimicrobial activity of antiseptics and wound irrigating agents used with commercially available wound dressings. Five clinically used antiseptics and wound irrigating agents (Prontosan, Lavasept, Braunol, Octenisept, and Betaisodona) were tested in the presence or absence of 42 wound dressings against Staphylococcus aureus. The determination of antibacterial activity was performed by disk diffusion assay. Povidone-iodine-based products showed sufficient antimicrobial activity in 64 to 78 percent of the combinations assessed (p > 0.01). The octenidine derivate Octenisept showed sufficient antimicrobial activity in 54 percent of combinations. Polyhexamethylene biguanide derivatives demonstrated sufficient antimicrobial activity in 32 percent of the combinations. This study revealed that commonly used wound dressings dramatically reduce antibacterial activity of clinically used antiseptics and wound irrigating agents in vitro.

A randomized double-blind controlled trial to compare a triclosan-containing emollient with vehicle for the treatment of atopic dermatitis

The use of topical antiseptics in the treatment of atopic dermatitis (AD) has previously been explored. However, no triclosan-containing leave-on emollient has been evaluated previously, to our knowledge. The aims of this study were to assess the safety and efficacy of an emollient containing triclosan compared with the emollient alone (vehicle) for the treatment of AD. Eligible patients with mild to moderate AD were randomized to receive either the study cream or vehicle. All patients also received a low-potency corticosteroid cream to use during the treatment phase of the study if necessary. Patients were assessed for severity according to the SCORing Atopic Dermatitis (SCORAD) Index, amount of corticosteroid used, patient assessment of cream, and adverse events (AEs). In total, 60 patients received either the study cream or vehicle, and an intention-to-treat analysis was performed. At day 14, there was a significant decrease in SCORAD from baseline for the study cream compared with vehicle (P < 0.05). At day 27, although there was an improved mean reduction from baseline, this was no longer significant (P > 0.05). Only four patients had mild treatment-related AEs. The mean total amount of topical steroid applied by the patients using the study was significantly lower than that used by controls (P = 0.40). Triclosan-containing leave-on emollient was safe and highly acceptable to patients. However, the overall benefit on day 27 was not significant. Nevertheless, the amount of topical steroid used by patients was significantly less with the study cream than with the vehicle, thus further studies are needed to confirm its steroid-sparing effect.

Silver resistance in MRSA isolated from wound and nasal sources in humans and animals.

Methicillin-resistant Staphylococcus aureus (MRSA) colonises skin, nasal passages and dermal wounds. Methods used to manage wounds infected and colonised with MRSA often include the use of topical antiseptics such as ionic silver and iodine. The objectives of this study were to determine the prevalence of silver-resistance (sil) genes in MRSA and methicillin-resistant coagulase-negative staphylococci (MR-CNS) isolated from wounds and nasal cavities of humans and animals, and also to determine the susceptibility of sil-positive and sil-negative MRSA isolates to a silver-containing Hydrofiber (SCH) wound dressing, on planktonic silE-positive and silE-negative MRSA. Polymerase chain reaction was used to determine the presence of three silver-resistance (sil) genes, silE, silP and silS in 33 MRSA and 8 methicillin-resistant staphylococci (MR-CNS). SilP and silS genes were absent in all isolates tested; however, two MRSA strains were found to contain the silE gene, together with one isolate of MR-CNS. Phenotypic resistance of the silE-positive strains and their susceptibility to the SCH dressing was evaluated using the zone of inhibition test on Mueller Hinton agar, and confocal laser microscopy using a live/dead fluorescent stain. Results confirmed that the SCH dressing was effective in killing all MRSA strains with and without the silE gene. First, this study showed that the prevalence of sil genes was low in the isolates investigated; and secondly, that the presence of a silver-resistance gene (silE) in MRSA and MR-CNS did not afford protection to the organism in the presence of a SCH wound dressing. The use of topical antiseptics in chronic wound care should be considered before the use of antibiotics that can result in their overuse and the risk of further resistance.