Antimicrobial activity of a new intact skin antisepsis formulation (original) (raw)

2003, American Journal of Infection Control

A growing number of percutaneous diagnostic and therapeutic procedures that put patients at risk for infections calls for tolerability and rapid antimicrobial activity-the prerequisites for efficient intact skin antisepsis. The frequently poor hospital infection control practices in venepuncture were recently highlighted, 1 including improperly washed hands and gloves worn only occasionally. The choice of antiseptic is also frequently wrong, and bacteria may contaminate the antiseptic solution, with increased skin transient microbial population. 2,3 Chlorine-based antiseptics have been used for skin antisepsis for more than 100 hundred years. A sodium hypochlorite solution (0.45% to 0.50%) prepared from chlorinated lime, sodium bicarbonate, and boric acid 4 was suggested a century ago; this formulation, however, presented irritating properties because of the presence of boric acid. Stability and tolerability were later improved after sodium carbonate and boric acid were replaced with sodium carbonate and sodium bicarbonate. 4 The latter formulation is still recommended to clean and disinfect dirty burns at lower concentrations. 5,6 Milton's fluids were introduced in pediatrics 9,10 more recently. Chloramine-T was the first successful organic chlorine derivative with documented bactericidal effects on the skin. 7 Chloramine-T also was shown to control virus infection. 8 Other organic chlorine derivatives have been developed, including N-chlorotaurine with bactericidal and virucidal properties documented by in vitro experiments, 9,10 and N-halamines, synthesized to stabilize the antimicrobial properties of chlorine, by "anchoring" this halogen on nitrogencontaining compounds. 11 Importantly, all organic chlorine derivatives develop "chlorine covers," bind