2. -:Introduction:-
Antimicrobial:- the substances derived from natural or
synthetic sources that kills or inhibit the growth of micro-
organism such as bacteria, fungi, protozoas
Germicides:- a group of drugs that are able to inhibit the
growth, development or leads to death of microorganisms in
the environment surrounding the patient or on the surface
of the body.
Specially agents which inhibits or kills microbes on
contact
They have low margin of safety
Non-systemic use
Non selective Antimicrobial agents
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3. GermicidesGermicides
ANTISEPTICS DISINFECTANTS
ANTISEPTICS:-ANTISEPTICS:- (Anti=(Anti= against; septicas – emitting a fetid
smell)
Chemical substances which are used to destroy, inhibit
pathogenic bacteria (not the spores) on animate (living)
surface such as skin, eye, mucous membranes(as in mouth
washes).
1879- Lister- Father of ‘Antiseptic surgery’
They falls under “ Drug Control Agency of the Government”
4. DISINFECTANTS
• Chemical substances or germicides which are use to destroy
or inhibit the growth of pathogenic vegetative bacteria (not
their spores) on inanimate(non-living) surface such as
glassware's or surgical instruments.
e.g.- Formaldehyde, phenol, ethyl alcohol, soaps.
They falls under “Control of Environmental protection
agency of the Government”
They process “concentration dependent killing”
Antiseptics & Disinfectant are often added to easily
available every day utilities like soaps,toothpastes,mouth
wash, after saving lotion.
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5. -:Some ancillary terms:-
1.Sterilization:-
Definition:- freeing an article, a surface or a medium by
removing or killing all micro-organisms including
vegetative bacteria, Spores, fungi & viruses
usually sterilization is affected by autoclaving at 15lb
pressure of stream at 120o
C for atleast 30 min
[It is the ultimate goal of any infection control protocol]
Other methods also include-
o Infra-red(IR)-radiation,
o Ultraviolet(UV)-radiation
o γ-radiation
6. 2. Decontamination:-
Marketed destruction of viable pathogenic organisms to a
level that will allow a healthy person’s natural
defenses to prevent any infection.
e.g.- Decontamination of water
3.Sanitisation:- reduction In microbial load from an
inanimate surface to a level set forth by public health
Department of Environmental Agency
These levels are considered acceptable for the health of
the population
7. 4. Pasteurisation:-
Process of heating milk or other liquids or semisolids for
about 30 min at 60-80o
C which kills the non-
sporulating microorganism and prevents the growth of
food-borne pathogens for a specific period of time.
5.Preservation:-
To preserve the efficacy & to prevent the deterioration of
the drug formulation up to its expiry period.
A Preservatives may protect the drug from oxidation.
e.g.-Benzyl Alcohol(2%),Benzoic Acid & its salts (0.2%)
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8. -:-:IDEAL Antiseptics/DisinfectantIDEAL Antiseptics/Disinfectant:-:-
• High Efficacy:High Efficacy:
– Broad spectrum / sporicidal / kill all formsBroad spectrum / sporicidal / kill all forms
– Rapid onset / long duration actionRapid onset / long duration action
– Cidal not static
– Active in presence of blood, pus,exudates and
excreta
– No Resistance
• Non Toxic:Non Toxic:
– Non-irritating to tissues,should not delay healing.
– Non absorbable / No hypersensitivity
– Chemically stable.Chemically stable.
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9. IDEAL ANTISEPTICS :IDEAL ANTISEPTICS :
• Added Advantage:-
– Non-staining with agreeable color and odour
– Could be added to soaps
– Non corrosive.
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10. MECHANISM OF ACTION:
1. Oxidation of Bacterial protoplasm.
e.g.- KMn04, H202, Halogens
2.Denaturation of Bacterial Proteins & Enzyme
e.g.-Phenols, Chlorhexidine, Alcohol, Aldehyde
3.Detergent like action increasing permeability
of bacterial membrane
e.g.- Soaps,Cetrimide
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11. FACTORS MODIFYING ACTIONFACTORS MODIFYING ACTION
• TEMPERATURE AND pH.
• PERIOD OF CONTACT WITH MICROBES.
• NATURE OF MICROBES INVOLVED.
• SIZE OF INNOCULUM
• PRESENCE OF BLOOD,PUS,OR ORGANIC
MATTER.
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12. General Uses of Antiseptics/ Disinfectants
• Asepsis before injections:-
• Surgical Uses:-
– Asepsis before surgery
– Scrubbing
– Sterilization of the surgical instruments
• Cuts, wounds & Lacerations
• Disinfection of Hospital premises
• Water purification & domestic disinfection
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15. PHENOL DERIVATIVESPHENOL DERIVATIVES::
• PHENOL (CARBOLIC ACID):-
• One of the earliest used Antiseptics & still the standard for
comparing other germicides.
• Weak agents Static at- 0.2% Bactericidal at >1%,
• Poor action bacterial spore
• Protoplasmic poisonProtoplasmic poison
MOA:- Denatured bacterial protein (irritant/toxic to tissues)(irritant/toxic to tissues)
-Mild LA action- use as Antipruritic Preparation-Mild LA action- use as Antipruritic Preparation
USESUSES:: Disinfectant of Urine,faeces pus,sputum,antipruriticDisinfectant of Urine,faeces pus,sputum,antipruritic
preparation mouth wash.preparation mouth wash.
Side effectSide effect:-Buccal, esophageal, gastric burns, scars/strictures:-Buccal, esophageal, gastric burns, scars/strictures
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16. CRESOL (METHYL PHENOL):-
• X3 potent than Phenol / less damage to tissuesX3 potent than Phenol / less damage to tissues
• USES:-USES:- Disinfecting of utensils, Excreta, for washingDisinfecting of utensils, Excreta, for washing
hands, irrigation of root canals.hands, irrigation of root canals.
CHLOROXYLENOL(DETTOL):-
• Non-corrosive, Non-irritating to intact skin,Non-corrosive, Non-irritating to intact skin, No stain,No stain,
4.8% commercial use “Dettol”(9% terpinol+13% Alcohol)4.8% commercial use “Dettol”(9% terpinol+13% Alcohol)
6.25%- Instruments6.25%- Instruments
Cream & Soap,Cream & Soap,
Lubricating obstetric cream (1.4% ).Lubricating obstetric cream (1.4% ).
• USESUSES:-:-
Surgical Antiseptics , skin cream, mouth wash, soaps, woundsSurgical Antiseptics , skin cream, mouth wash, soaps, wounds
& cuts& cuts
24. HALOGENS:HALOGENS:-
• IODINE:
USES:USES: ((1:20,000 , SOLN KILL VEGETATIVE FORM- ANTISEPTIC1:20,000 , SOLN KILL VEGETATIVE FORM- ANTISEPTIC
USES)USES)
1.TINCTURE IODINE (2.5% IN ALCOHOL)1.TINCTURE IODINE (2.5% IN ALCOHOL)
2.MANDL’S THROAT PAINT2.MANDL’S THROAT PAINT (1.25% IN POT .IODIDE) FOR(1.25% IN POT .IODIDE) FOR
SORE THROAT.SORE THROAT.
3.COUNTER IRRITANT3.COUNTER IRRITANT
4. WATER PURIFICATION4. WATER PURIFICATION..
ADRsADRs:: CORROSIVE,BURNS,BLISTERS, RASHES, stain,CORROSIVE,BURNS,BLISTERS, RASHES, stain,
irritant, less duration of actionirritant, less duration of action
• To be kept in dark colored bottles.To be kept in dark colored bottles.
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39. • 2.PHENYL MERCURIC NITRATE2.PHENYL MERCURIC NITRATE::
USES: IN TINEA REMEDIES,ANORECTAL
PREPARATIONS, OTIC, OCULAR
PREPARATIONS & PRESERVATIVES.
MERBROMIN (Mercurochrome):
• BRIGHT RED, ORGANIC MERCURIAL.
• NON-IRRITATING & LESS TOXIC.
• USES: 1-2% FOR EYES AND SKIN
antiseptic.
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40. SILVER COMOUNDSSILVER COMOUNDS::
• ASTRINGENT & CAUSTIC.
• REACT WITH -SH,-COOH,-PO4,-NH2 PROTEINS.
• SILVER NITRATE (slow Ag release)SILVER NITRATE (slow Ag release)
• RAPIDILY KILLS MICROBES.
• USES: Opthalmia Neonatarum (1% soln.) SOLN.,
APTHOUS ULCER
• Demerits: black discoloration of tissues
SILVER SULFADIAZINE:
• No black discoloration.
• USES: AS OINTMENT IN BURNS / effective in
Pseudomonas inf..
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41. ZINC SALTSZINC SALTS::
• ASTRINGENT & MILD ANTISEPTICS.
• 1.ZINC SULFATE: WATER SOLUBLE.
• USES: EYE & EAR DROPS, Mouth wash,
EYE WASH, FOR ACNE AND IMPETIGO,
Lotiocalamine (Zno + Calamine), Anti Perspirants.
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42. DYES:DYES:
• Complex organic substances derived from coal tar
• Gentian violet (crystal violet):
• Rosaniline dye.
• Active against staphylococci,gram +ve bacteria, fungi.
• Uses: alcoholic soln (0.5%) for furunculosis, bed sores,
chronic ulcers,infective eczema, thrush, ringworm.
• Demerits- poor efficacy against Gm-ve & in the
presence of pus, blue stain on skin
Briliant green :-rosaniline dye.
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43. • Acridine Dyes: Acriflavin and Proflavin:
• Orange-yellow acridine dyes
• Active against gram + ve bacteria &gonococci.
• Sensitive to light & lose efficacy
• Effective in alk. pH
• Non irritant.
• Uses: chronic ulcers,wounds, burn dressings, Triple dye
lotion-gentian violet 0.25%+briliant green 0.25%+
acriflavin 0.1% for burns. Dressing in umbilical stump in
neonates.
• Demerits- to be stored in amber coloured bottles
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44. FURAN DERIVATIVES:FURAN DERIVATIVES:
• Nitrofurozone:
• Cidal for gram +ve & gram –ve,aerobic
&anaerobic bacteria.
• Inhibits enzymes for carbohydrates metabolism.
• Use- Efficacious in burns,skin grafting.
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Selective action / high therapeutic index
Non-irritating- this feature can be used to add the antiseptic to soaps- used for scribbing & surgical uses.
Selective action / high therapeutic index
Preoperative sterilization of the skin
Scrub- disinfection of hands of surgeons /dentists / nurses etc
Phenol- 1st intro- Lister
All phenols- INHIBIT BACTERIAL ENZYMES-BACTERIAL LYSINS
CHLOROXYLENOL-DETTOL- less effective in presence of organic matter
Hexachlorophene- less effective in presence of organic matter, pus
Sustained action- fine film formed on skin- not removed by water rinsing
Hexyresorcinol- non stain, odourless-
are menthol, thymol, methyl salicylate, and eucalyptol
sensitve to light- so to be kept in dark (amber coloured) bottles.
Rusting- so it should not used for cold sterilization of surgical instruments & also that the storage container shud not be of metal!!!
wound cleaning- by foaming action
Inhibits enzyme. Oxidizes protoplasm (so also can be included in oxidizing agents)
Broad spectrum- bacteria, fungi, spores, virus
Inhibits enzyme. Tincture I- degerming of skin- preoperatively/ surgical instruments (cold sterilization), wounds & cuts, ring worm.
Root canal therapy- Irrigation of root canals- widely used (root canal therapy-????- read)
CHLORAMINE- less irritant
CONGEALED BLOOD (ROAD ACCIDENTS)
Can be added to soap, cuts & wounds/ fine film formed on skin or muc. membranes- not removed by water rinsing
Another Biguanide is also Metformin (in T2DM)!!!???