ANTISEPTICS & DISINFECTANTS

Sterlization
Freeing of an article, surface or medium by remo ing or !illing all micro"organisms including egetati e form of bacteria, s#ores, iruses, fungii

Disinfection
Destruction or in$ibition of gro%t$ of all #at$ogenic organisms &bacteria, iruses, fungii' on non li ing surfaces If s#ores are also !illed #rocess is Sterlization

Antise#tics
T$ese are c$emical substances %$ic$ in$ibit t$e gro%t$ or !ill micro" organisms on li ing surfaces suc$ as s!in & mucous membrane(

Pro#erties of good antise#tic) disinfectant

*( Cidal +( Non staining & good odour ,( Acti e against all #at$ogens -( Acti e in #resence of #us, blood & e.udates /( 0a#id acting 1( Non irritating to tissues ) non corrosi e 2( Non absorbable 3( Non sensitizing)

4ec$anisms of action of antise#tic and disinfectants

5.idation of bacterial #roto#lasm
Potassium #ermagnate, 6+7+, 6alogens

Co"agulation &denaturation' of bacterial #roteins & disru#t cell membrane

P$enols, c$lor$e.idine, alco$ols, alde$ydes

Detergent li!e action #ermeability of bacterial cell membrane

Cetrimide, soa#s

Classification
P$enol deri ati es8
#$enol, cresol, $e.ac$loro#$ene, c$loro$e.ylenol &dettol'

5.idizing agents8
6ydrogen #ero.ide(

6alogens8
Iodine, c$lorine, c$loro#$ores(

9iguanides8
C$lor$e.idine(

:uaternary ammonium8
Cetrimide(

Alco$ols8 Et$anol, iso#ro#anol Alde$yde8 Formalde$yde Acids8 Acetic acid, boric acid 4etallic salt8 4ercuric com#ounds , sil er & zinc salts Dyes8 ;entian iolet, acrifla ine

P$enol
Earliest used, reference standard Proto#lasmic #oison,
in<ures tissues & cells at $ig$ conc causes s!in burn

45A8
denaturating bacterial #rotiens(

=SES 8
To disinfect urine, faeces, #us, burns(

E.tremely irritating, corrosi e

C0ES5> &>ysol'
4et$yl Deri ati e of #$enol, less damaging to tissues t$an #$enol( ,"*7 times more acti e used for disinfection of utensils, e.creta & for %as$ing $ands(

C$loro.ylenol &Dettol'
P$enol deri ati e Does not co"agulate #roteins, Non corrosi e,Non irritating to s!in Commercial -(3 ? solution used for surgical antise#sis S!in cream and soa#8 7(3? 4out$ %as$ *?

6e.ac$loro#$ene
Commonly incor#orated in soa# Effecti ely only against ;m@ e Slo% but #ersistant action A+? #re#arations banned

5.idizing agents
Potassium #ermagnate8
Pur#le crystals, $ig$ly %ater soluble, liberates o.ygen %$ic$ o.idizes bacterial #roto#lasm( =sed for gargling, irrigating %ounds, uret$ra &condyBs lotion diluted solution of *8-777 to *8*7,777 ' 6ig$ conc cause burns It is also used to disinfect %ater in #onds( Stomac$ %as$ in al!aloidal #oisoning

5.idizing agents
6ydrogen Pero.ide
liberates nascent o.ygen %$ic$ o.idizes necrotic matter & bacteria( 6el#s in loosening & remo ing sloug$, ear %a. etc(

9enzoyl Pero.ide
Cidely used drug for acne( liberates 5+ in #resence of %ater %$ic$ !ills bacteria, s#ecially anaerobes

6alogens
Iodine, Iodo#$ores, C$lorine, C$loro#$ores

Iodine
0a#idly acting broad s#ectrum &bacteria, fungi, irus' Acts by iodinating and o.idizing microbial #roto#lasm( =sed for cuts, degerming s!in before surgery( Ad erse effect8 cause burns & blisters

Iodo#$ores
Dno%n as #o idine iodine( Non to.ic, non staining #rolonged action( =sed on boils, furunculosis, burns, ulcers, tinea, surgical srub, disinfecting surgical instruments, non s#ecific aginitis(

C$lorine
#otent germicide( Dills #at$ogens in ,7 sec( used to disinfect urban %ater su##lies( 7(* to 7(+/ ##m

C$oloro#$ores
&*' C$lorinated lime &bleac$ing #o%der'
obtained by action of c$lorine on lime( used to disinfect drin!ing %ater

&+' Sodium $y#oc$lorite

Po%erful disinfectant used in dairies for mil! cans( Too Irritant to be used as antise#tic( 0oot canal t$era#y in dentisry

9iguanides
C$lor$e.idine8 &Sa lon'
Acts by disru#ting bacterial cell membrane & denaturation of bacterial #roteins Non irritant ,more acti e against gram @ e bacteria( =sed in for surgical scrub, neonatal bat$, mout$ %as$ & general s!in antise#tic( 4ost %idely used antise#tic in dentisry 7(*+" 7(+? oral rinse or 7(/ "* ? toot$ #aste

:uarternary ammonium antise#tics cetrimide

Detergents8 Cidal to bacteria, fungi & iruses( Act by altering #ermeability of cell membrane Efficiently remo e dirt and grease Cidely used as antise#tics & disinfectants for surgical instruments, glo es etc Combined %it$ c$lor$e.idine &sa lon'

Soa#s
Anionic detergents Cea! antise#tics %it$ cleansing action Cas$ing %it$ soa# and %arm %ater one of t$e most effecti e met$ods of #re enting disease transmission Affect only ;m@ bacteria

Alco$ols
Et$anol
Antise#tic, cleansing agent at -7"E7? conc( Act by #reci#ating bacterial #roteins Irritant, s$ould not be a##lied on mucous membrane, ulcers, o#en %ounds(

Alde$ydes &Formalde$yde'
=sed for fumigation( ,2 ? aFueous solution called as formalin( Proto#lasmic #oison , denaturates #rotiens( =sed for #reser ing dead tissues( =se as antise#tic restricted due to bad odour & irritation ;lutaralde$yde is a better sterlizing agent

Acids
9oric acid %ea! antise#tic , bacteriostatic( used for mout$ %as$, irrigation eyes, glossitis( Ad erse effect8 omiting ,abdominal #ain on systemic absor#tion(

4etallic salts
SI>GE0 C54P5=NDS Sil er sul#$adiazine is acti e against #seudomonas seen in burns #atient( Sil er nitrate $ig$ly acti e against gonococci HN SA>TS 4ild antise#tic, used as eye %as$, ear dro#s(

Dyes
;entian iolet8
Acti e against bacteria &gram @ e', fungi =sed on c$ronic ulcers, furunculosis, bed sores, ring %orms(

Acrifla ine
Acti e against gram @ e bacteria & gonocci suitable for c$ronic ulcers & %ounds Do not retard $ealing, non irritant

Ecto#arasiticides
T$ese are drugs used to !ill #arasites t$at li e on body surfaces lice I cause #ediculosis &$air infection' mites I cause scabies&s!in infection'

Drugs used are

&*' PE04ET60IN &+' >INDANE &,' 9ENHJ> 9ENH5ATE &-' IGE04ECTIN &/' C05TA4IT5N &1' S=>F=0

Permet$rin
9road s#ectrum causes neurological #aralysis in insects( *77 ? cure rate nearly Single a##lication needed in most cases( Fe% #atients e.#erience itc$ing ,burning( first drug of c$oice for scabies & #ediculosis( Scabies8 a##ly all o er t$e body e.ce#t face & $ead ( Cas$ after 3" *+ $rs( 6ead louse8 after *7 min( massage about ,7 g in to scal# and %as$

>indane
9road s#ectrum insecticide %$ic$ !ills lice and mites by #enetrating t$eir c$itinous co er Pro#erties similar to #ermet$rin( Cure rate lo% & resistance seen( Disad antage8 being li#id soluble CNS to.icity li!e ertigo , con ulsions seen( A##lication similar to #ermit$rin( combination %it$ benzyl benzoate is more effecti e(

9enzyl benzoate
5ily liFuid %it$ aromatic smell( Cure rate 21 K *77? L second a##lication reFuired after +- $rs( To.icity is lo%( A##lication similar to #ermet$rin( =se $as declined due to s!in irritation( Contra indicated in c$ildren because of neurological sym#toms & s!in irritation( combination %it$ lindane $ig$ly effecti e(

Crotamiton
lo% cure rates 9etter results if a##lied for / days in c$ildren >ess irritation and to.icity 4ay be #referred in c$ildren as second c$oice

I ermectin
Anti $elmint$ic drug %$ic$ $as been recently found effecti e against scabies & #ediculosis( A single 7(+ mg )!g & *+mg in adults' $as E*" *77 ? cure rate( Contra indicated in c$ildren < /yrs , #reganant & lactating %omen(