The document discusses the potential for using essential oils in conjunction with traditional antiseptic solutions to more effectively eliminate microbes. It summarizes studies that found using essential oils like eucalyptus oil with chlorhexidine increased the penetration and antimicrobial efficacy of the chlorhexidine. One study detected chlorhexidine 1050 micrometers into skin tissue when combined with essential oils, compared to usual depths of 50-100 micrometers. A clinical trial found applying essential oils and antibiotics to cancer patients' infected ulcers improved healing and quality of life by eliminating foul odors and infections. The document concludes that essential oils show promise in evidence-based practice when used with antiseptic substances but further research is still needed.

1. Running head: ANTIMICROBIAL EFFECTS OF ESSENTIAL OILS 1
The Use of Essential Oils to Increase Effectiveness of Antiseptic Substances
Megan E. Peterson
University of Wyoming
Fay W. Whitney School of Nursing

2. Running head: ANTIMICROBIAL EFFECTS OF ESSENTIAL OILS 2
Eliminating microbes and working under sterile conditions are a routine part of nursing
care. Maintaining a high standard of care in creating an environment free of invasive microbes
is a continuing challenge in healthcare. Overtime, many of the common microbes, such as
Staphylococcus aureus, have developed strains resistant to a number of medicinal therapies
used to eradicate them from the infected host. This problem has caused the medical and
pharmaceutical community to seek stronger and more effective methods of destroying these
microbes. The question of using alternative antimicrobial products in conjunction with
traditional substances to enhance efficacy is proposed as such: In patients receiving antiseptic
wound care, does the use of essential oils in conjunction with antiseptic solutions, compared to
using antiseptic solutions solely, effectively eliminate microbes during the cleansing procedure?
Products such as 70% isopropyl alcohol and chlorhexidine digluconate (CHG) are
commonly used topical agents used to eradicate microbes from the surface of patient skin
before invasive therapeutic measures are taken, like the insertion of intravenous catheters.
Microbes such as S. aureus and S. epidermidis live on the surface of human skin, and can also
colonize deeper into the epidermis layers where they have a tendency to show greater
resistance to antimicrobial substances. It has been reported that the substance CHG is
bacteriostatic in nature and if inadequate concentrations are used to clean antiseptically,
microorganisms such as S. epidermidis are then able to survive and reproduce. The potential
insufficient eradication of surface and subsurface microbes is the cause of hospital-acquired
infections. (Karpanen, Worthington, E.R., Conway, & Lambert, 2008)

3. Running head: ANTIMICROBIAL EFFECTS OF ESSENTIAL OILS 3
It has been proposed that the use of essential oils in addition to commonly used
chlorhexidine can increase permeation of the skin, in order to destroy subsurface colonies, and
enhance the antiseptic effects of CHG. A study of CHG/eucalyptus oil (EO) permeation on
human donor skin, had a positive report of enhanced permeation of CHG when used in
combination with varying potencies of eucalyptus oil, and in combination with 70% isopropyl
alcohol. Permeation depths were measured by multiple punch biopsies 2 minutes, 30 minutes
and 24 hours after exposure to the topical mixtures. CHG was detected in thicknesses up to
1050 micrometers of tissue in mixtures containing 2% CHG and 5%, 10%, 20% eucalyptus oil.
The greatest permeation was seen in a mixture of 2% CHG and 50% concentration EO at a
thickness of 1500 micrometers. (Karpanen, Conway, Worthington, HIlton, & Lambert, 2010)
Essential oils such as eucalyptus oil contain an organic compound titles 1,8-cineole which is
thought to use a very similar mechanism of destroying bacterial cell membranes as CHG. This
combination is speculated to increase efficacy of CHG in eliminating infectious biofilms from
surface skin and equipment such as IV catheter hubs. (Karpanen et al., 2008)
In a clinical trial of 30 terminally ill cancer patients, a mixture of essential oils, including
tea tree oil and eucalyptus oil, and antibiotics were applied to necrotic ulcers of the head and
neck. These ulcers were superinfected with bacteria such as E. coli and at present were not
healing. These ulcers also had a particularly foul odor which was adversely affecting quality of
life for these patients. Upon admission, these ulcers were treated with topical antibiotics and
essential oils to combat the infection and offending odor. In addition to the odor eliminating
effects of essential oils, the mixture enhanced the patient’s quality of life through diminishing
superinfections and promoting reepithilialization of the affected areas. The essential oil and

4. Running head: ANTIMICROBIAL EFFECTS OF ESSENTIAL OILS 4
antibiotic mixture was able to eradicate the E. coli superinfection, elminate the odor and
promote healing in these otherwise ‘unhealing’ wounds. (Warnke, et al., 2005)
In our clinical use of essential oils we observed not only the previously described
antibacterial effect but also an anti-inflammatory effect. It also became apparent that
the topical use of essential oils promoted a small degree of re-epithelialization of
neoplastic facial ulcers… (Warnke, et al., 2005)
After use of the antibiotic/essential oil mixture, patients reported a better quality of remaining
life. The topical mixturehadeffectivelyridthe patientof the offendingodor,andamarkedimprovement
in healing of the ulcers had taken place. Because of this, patients reported less isolation from friends,
familyandotherpatients.Thisinturnenhancedoverall moodandself-esteemforthe remainderof their
lives.
To conclude, the use of essential oils with current antiseptic substances have shown positive
resultswhichsupportthe questionof validityinitsuse inclinical practice.Thesefindingsshouldbe further
investigatedandeffortsshouldbe made tostandardizeessential oilproductionand manufacturingtoput
the qualityof these productsonpar withCHG.To combatthe increase inresistantstrainsof bacteriaand
minimize hospital-acquiredinfections,alternative productsandstrategiesmustbe studied.Essential oils
show great promise in evidence based practice of aseptic cleansing.

5. Running head: ANTIMICROBIAL EFFECTS OF ESSENTIAL OILS 5
Works Cited
Karpanen,T.J., Conway,B.R., Worthington,T.,HIlton,A.C.,& Lambert,P. A.(2010). Enhanced
Chlorhexidine SkinPenetrationwithEucalyptusOil. BMCInfectiousDiseases,1-6.
Karpanen,T.,Worthington,T.,E.R.,H., Conway,B.,& Lambert,P. (2008). Antimicrobial Efficacyof
Chlorhexidine DigluconateAloneandinCombinationWithEucalyptusOil,TeaTree Oil and
Thymol AgainstPlanktonicandBiofilmCulturesof Staphylococcusepidermidis. Journalof
AntimicrobialChemotherapy,1031-1036.
Warnke,P.H., Becker,S. T.,Podschun,R.,Sivananthan,S.,Springer,I.N.,Russo,P.A.,. . . Sherry,E.
(2009). The Battle AgainstMulti-ResistantStrains:Renaissance of Antimicrobial Essential OilsAs
A PromisingForce toFightHospital-AcquiredInfections. Journalof Cranio-MaxillofacialSurgery,
392-397.
Warnke,P.,Sherry,E., Russo,P.,Acil,Y.,Wiltfang,J.,Sivananthan,S.,... Springer,I.(2005). Antibacterial
Essential OilsinMalodorousCancerPatients:Clinical Observationsin30 Patients.
Phytomedicine,463-467.

6. Running head: ANTIMICROBIAL EFFECTS OF ESSENTIAL OILS 6
Karpanen,T.J., Conway,B.R., Worthington,T.,HIlton,A.C.,& Lambert,P. A.(2010). Enhanced
Chlorhexidine SkinPenetrationwithEucalyptusOil. BMCInfectiousDiseases,1-6.
Thisarticle studiesthe use of essentialoilssuchasEucalyptus(EO) inenhancingthe efficacyof
chlorhexidinebyenablingthe antiseptictopenetrate deeperintothe skin.The testswere performedon
donated humanskin,andseveral testswere done withmixturesof CHGand EO at variousstrengths.
Punchbiopsieswere testedat2 minutes,30 minutesand24 hour intervalstomeasure amountof
permeationthroughskinthickness.Resultsshowedincreasedpermeation of CHGcombinedwithEO,
withoptimal permeationat10% (v/v) EOand 50% EO. These findingsare of particularinterestbecause
theycouldbringaboutnewpracticesin increasingantisepticpropertiesof currentproducts.Using
chlorhexidinewitheucalyptus oil couldhelptoreduce HAI.The methods,materials,andresultsof this
studywere well-definedandappropriatelyconveyedthroughtextandgraphical data.Ifeel thatthis
studyfallsinline withmyPICOTquestionandhelpstoforma supportedargumentforthe use of
essential oilsinevidence-basedpractice.
Warnke,P.H., Becker,S. T.,Podschun,R.,Sivananthan,S.,Springer,I.N.,Russo,P.A.,. . . Sherry,E.
(2009). The Battle AgainstMulti-ResistantStrains:Renaissance of Antimicrobial Essential OilsAs
A PromisingForce toFightHospital-AcquiredInfections. Journalof Cranio-MaxillofacialSurgery,
392-397.
Thisarticle chroniclesthe testingof essentialoilsandtheirantimicrobialpropertiesagainstseveral
strainsof bacteriasuch as MRSA and Streptococcusstrains.The essential oilsusedincludedteatree oil,
lemonoil,thyme whiteoil andcinnamonoil.13differentessential oilswere testedagainstchlorhexidine
and hydrogenperoxide fortheirbactericidal properties;eachoil wastested3timesandcontrol oilsof
olive oil andparaffinoil were used.Thyme whiteoil,lemonoil,lemongrassoil,cinnamonoil andteatree
oil consistentlyhadthe greatestinhibitoryeffectsagainstcommonhospital-acquiredinfectiousbacteria.
Interestingissueswerebroughttolightaboutthe use of essential oilstoaidinantisepticpropertiessuch
as inconsistencyinconcentrationof the active componentsinoilsfromdifferentmanufacturers,lackof
standardizationinproduction,andthe change inefficacyfromdifferingplantfamilies.The methods,
materialsandresultsof thisstudywere well-definedandclearlyconveyedthroughthe writingand
graphical data.I thinkthat thisstudysupportsmy PICOTquestionandhelpsmake avalidargumentfor
the use of essential oilsintherapeuticpractice.