Antiseptics: Applications and Precautions

Antiseptics: Applications and Precautions

1. Introduction

Antiseptics are chemical substances that kill or inhibit the growth of disease-causing microorganisms, including bacteria, fungi, viruses, and spores. The use of antiseptics is an essential part of preventing and treating infections.

2. Common Types of Antiseptics

• Alcohol: Ethyl alcohol is commonly used in concentrations ranging from 25% to 70% for optimal efficacy. Its mechanism of action is to denature the protein of microorganisms.

• Iodine Alcohol: Iodine alcohol solution contains 2% iodine, 2.4% potassium iodide, and 44-50% alcohol.

• Povidone-iodine: Povidone-iodine is a complex compound with iodine, which releases iodine slowly, prolonging the antibacterial effect.

• Hydrogen Peroxide: It has an oxidizing effect, generating free radicals, damaging the bacterial membrane, DNA, and cellular components.

• Silver: Silver ions precipitate proteins and prevent bacterial metabolism.

• Antibacterial Soaps: They disrupt the cell membrane of bacteria, particularly Gram (+) bacteria.

3. Effects of Antiseptics

• Alcohol: Kills bacteria, fungi, and viruses but has no effect on spores.

• Iodine Alcohol & Povidone-iodine: Rapidly kills bacteria, viruses, and fungi, including spores. Povidone-iodine has the advantage of being more stable than iodine alcohol at room temperature, less irritating to tissues, and less corrosive to metals.

• Hydrogen Peroxide: Kills bacteria, viruses, and fungi at concentrations of 3-6%. Higher concentrations above 10% can kill spores.

• Silver: Has an antiseptic effect.

• Antibacterial Soaps: Strong effect on many bacterial strains, remains on the skin for a long time, prolonging efficacy.

4. Adverse Effects

• Alcohol: Exercise caution when applying to open wounds and severe burns, as it can cause dryness, skin irritation, and flammability.

• Povidone-iodine: High cost, toxic to fibroblasts (delayed wound healing), contraindicated for those with allergies, pregnant and breastfeeding women, children under 2 years old, and people with thyroid dysfunction.

• Iodine Alcohol: Irritates the skin, causes stinging, stains the skin, and can cause iodine toxicity when applied extensively. Contraindicated for direct application to mucous membranes of extensive and deep wounds, eyes, people with allergies, children under 2 years old, pregnant and breastfeeding women, and people with thyroid dysfunction.

• Hydrogen Peroxide: Toxic to fibroblasts, delays wound healing. Do not use under pressure to irrigate deep wounds as it can create air under the skin.

• Silver: Long-term use can cause argyria. Silver-Sulfadiazine 1% applied extensively and long-term can reduce white blood cells.

• Clorhexidine Antibacterial Soap: Low toxicity on intact skin, does not irritate, does not absorb through the skin and mucous membranes. On wounds, it can cause hypersensitivity reactions, dizziness, dry mouth, and heart rhythm disturbances.

5. Clinical Applications

• Alcohol: Used alone or in combination with other antimicrobial agents.

• Iodine Alcohol & Povidone-iodine: Antiseptic and disinfectant.

• Hydrogen Peroxide: Mouthwash, cleaning surface, superficial, and shallow wounds, prosthetic devices.

• Silver: Silver-Sulfadiazine 1% cream has antiseptic and antibacterial effects. Silver nitrate (argyrol 1%) prevents gonorrhea-related eye inflammation, has good antibacterial properties, and can be used for newborns.

• Clorhexidine: Antiseptic, disinfectant. Used in antibacterial soaps, irrigation solutions, mouthwashes, wound irrigation (4% solution).

6. Principles of Antiseptic Use

• On Intact Skin: Wash away sebum, apply antiseptic.

• On Wounds: Measure pH, identify bacteria (if necessary), clean the wound, wash with antibacterial water, apply appropriate medicine for the wound’s pH.

Note: Consult a doctor or pharmacist before using any antiseptic, especially for open wounds and children.