DESINFECTANTS AND

ANTISEPTICS
ARJO SURJANTO
SCHOOL OF NURSERY
BANDUNG POLYTECHNIC OF HEALTH
Antiseptics and disinfectants are fundamentally different to
active systemic chemotherapeutics. Almost all of this group are
toxic, while other chemotherapeutics have selective (or less)
toxicity almost all of antiseptics and disinfectants could
eradicate of germ population on nonliving objects, even so
applied to human body topically.
Disinfectants define as agents that eradicate microorganism on
nonliving matters
Antiseptics define as agents that inhibit germ on the surface of
living tissue either in vitro or in vivo
Antibacterial action of antiseptics or disinfectants very depend
to concentration, temperature and time. Lower concentration
could stimulate bacteria growth, higher concentration inhibit
microorganism, and more higher would killing certain
microorganism
Antiseptics and disinfectants are difficult evaluated. Methods of
evaluation are debatable. Even more, ideally, disinfectant had
to kill microorganism on a high dilution, not to damage tissues
or nonliving matters, cheap, stable, colorless, odorless, rapid
action. There are not matters passed all points above.
INTRODUCTION (1)
A lot of antiseptics and disinfectants are applied in the same
time in medic and surgery practical. Nowadays, there are
substituted by chemotherapeutics. For example: Mupirosin, a
new antibacterial agent, is gain from Pseudomonas that inhibit
staphylococcus and streptococcus by disturbance of RNA and
its protein synthetic. Even more less in systemic, topically they
are effective to skin infection
A lot of topical antiseptics are not assisting in wound curing.
Generally, water cleansing or soap application are more
effective and less damage on abrasion or superficial wound.
Agents that given topically on mucosa or skin, usually non
regular absorbed and could not predictable. Wound nursing by
thin plastic covering, usually increase absorption. Medicine
penetration via skin epithel depend on relative humidity and
temperature.

INTRODUCTION (2)
ALCOHOL
Aliphatic alcohol is antimicrobial agent in several degree
by changing protein property. Ethanol (ethyl alcohol)
70% is bactericide in1 -2 minutes on 30 C.
Ethyl alcohol 70% and iso propyl alcohol (isopropanol)
90% are satisfying general antiseptics for skin
superficial. Both of them are used to sterilized to
instrument, however either alcohol or isopropanol are not
effective to spore.
Alcohol 70% aerosol which its droplet 1um could
became effective disinfectant for mechanical respiratory.
Prophylen glicol and other glycol steam are applied as
air sterilize. Humidity control should be done to definite
good working of its antibacterial effect. Nowadays, glycol
steam application is rarely
ALDEHIDE
Formaldehide in concentration of 10% could killing
microorganism and its spore during 1 6 hours.
Formaldehide joint the protein of microbe and
precipitate it.
Hence, aldehide is too irritate for tissue, but it is wide
application as instrument disinfectant. Solution of
formaldehide contains formaldehide 37% (on weight)
added methyl alcohol to prevent polymerization
Glutaraldehide as a base solution of isopropanol 2%
(pH 7.5 8.5) is liquid disinfectant for optical
instrument and several prosthetic matter.it could killing
in 10 minutes and its spore in 3 10 hours, however
this solution is not stable and tissue contact on it must
be avoid.
Methenamin oral should release formaldehide to acid
urine. Application of methenamin is on urethra sepsis
ACIDS
Several inorganic acids are used as tissue
cauterization. It could become as anti
microbe agent, but its tissue destruction
prohibit its application. Water solution of
boric acid 5% or in powdered form could
applied on skin lesion as anti microbe
agent. However, its absorbed toxicity is
enough high (especially for children) and it
is not recommended.
HALOGEN AND HALOGENATED
COMPOUND (1)
IODIUM
Iodium is effectively germicide. Its mechanism of action is not clearly
known. Solution of 1:20,000 could kill bacteria on a minute, and spore on
15 minutes, and its tissue toxicity relatively lower. Iodium tincture USP
contain iodium 2% and sodium iodida 2.4% in alcohol
Iodium tincture is effectively antiseptics stocked on whole skin. It could
applied for removal of culture blood from vena. The main detriment is
sometimes dermatitis appeared on hypersensitive individu. It is prohibit
by loosing of iodium tincture with alcohol
Iodium joints with polyvinyl pyrolidon to produce povidon iodium USP
as an iodofor. This compound is a water soluble complex that release
free iodium in solution (for example: 1% of free iodium in 10% solution)
Iodofor application is wide as a skin antiseptic, especially to clean skin
before operation. This compouds kills vegetative organism and spore.
Hypersensitive reaction sometimes happen.
Povidon iodium is stocked in several form: solution, ointment, aerosol,
surgical scrub, shampoo, skin cleanser, vaginal gel, vaginal douche and
cleanser cotton
CHLOR
Chlor acts as an anti microbe in non dissociated hypochloric acid
form (when it solute in water). Its concentration of 0.2 5 ppm is an
effective bactericide except microorganism that 5000 times
resistance
Inorganic compounds reduce chlorine antimicrobial activity
chlorine demand. Chlorine demand for relative pure water is low and
addition of 0.5 ppm disinfectant. For polluted water, it is need 20
ppm or more to gain bactericidal effect
Chlor is used as death matter disinfectant especially water.
Halazon USP is an chloramine tablet applied to sterilize drinking
water in a small quantity. Addition 4 8 mg halazon per litre would
sterilize water in 15 60 minutes, except there are a lot of organic
bodies. Halazon could not inactivated cyste of E. hystolitica
Sodium hypochlorite USP 0.5% contain about 0.1 per deciliter could
applied as irrigation liquid and disinfectant contaminated wounds

HALOGEN AND HALOGENATED
COMPOUND (2)
OXYDATORS
Several antiseptics are given antimicrobial effect because they are
oxidators. Several of them are commonly like hydrogen peroxide,
sodium perborate, and potassium permanganate.
Solution of Hydrogen peroxide USP contains 3% H
2
O
2
on water.
Tissue contact made an oxygen release short antimicrobial effect.
There is not tissue penetration
Hydrogen peroxyde is mainly applied as collution and wound
cleanser. This material should applied to disinfect soft contact lens.
Benzoil peroxyde hydrate USP could appear as bactericide to
microbe, when it use on skin keratolytic, anti seborrhoic, and
irritants. It applied in acne and seborrhea medication.
Potassium permanganate USP is a violet crystal of KMnO
4

dissolved in water. Dilution up to 1 : 10,000 could killing a lot of
microorganism in an hour. Higher concentration should irritate
tissue. Mainly application of Potassium permanganate is in wet
lesion medication
HEAVY METAL (1)
Mercury
Mercury ion should precipitating protein and sulfhydril
enzyme. Microorganism inactivated by mercury could
reactive by thiol (sulfhydril compound). Antiseptic
mercury inhibit sulfhydril enzyme in tissue and bacteria
too mercury preparate is very toxic orally.
Mercury bichloride NF (1:100) could applied as
disinfectant either instrument or whole skin
Organic mercury is less toxic than inorganic salt and
more antibactericide. Nitromersol USP, thymerosal USP
(Merthiolate) and phenyl mercury acetate or nitrate
should marketed in various liquid or solid as
bacteriostatic antiseptic
Silver
Silver ion precipitate protein and disturb essential metabolic activity of microbe
cell. Inorganic silver salt in solution is strong bactericide. Silver nitrate 1 : 1000
attack a lot of microorganism immediately contact
Silver nitrate solution USP contain 1% silver salt, should dropped on neonatal
eye as a prophylaxis of gonococcus opthalmia. It cause cojunctivitis when over
acidity to prohibit : nowadays antibiotic ointment applied. Other inorganic
silver salt is rarely applied because of its irritation on tissue.
Compress solution of silver nitrate 5% usually applied on burning wound. It
would decreasing of infection, increasing velocity of eschar formation, and
decrease og death rate. Since silver nitrate should reduced to nitrite by bacteria
on burning wound methemoglobinemia formed.
Silver sulphadiazine cream has a several benefit and less of sickness than
maphenite acetic on burning wound medication. It slow release of either silver
nitrate or sulphadiazine to decrease effectively flora of microbe in burning
wound.
Silver colloidal preparate is more less damage on superficial tissue and has
significant anti bacterial. Mild silver protein contains about 20% of silver and
could applied as mucose membrane antiseptics. Long duration of silver
application cause argiria.

Other metal
Zink sulphate and copper sulphate have a significant anti bacterial, but seldom
applied in medicines
HEAVY METAL (2)
SOAP
Soap is anionic matter which active in surface, usually
sodium or potassium of vary fatty acid. It is variety on
composition depend on specific fatty or oil and certain base
from which it made. Since NaOH or KOH are strong base,
while fatty acid is weak acid when it solute in water
strong base condition (pH 8,0 - 6,5) skin irritant. Special
soap (like Neutrogena) applied triethanol amine as base,
when it solute pH almost 7. Although a lot of soap is well
tolerate excess application causes dry skin. Addition of
perfume synthetic causes irritate or sensitization of skin.
A lot of usual soap could lost dirtiness also on skin surface
secretion, desquamation epithelia, and its bacteria
contained
Phisical action like washing hand with usual soap is
enough effective to lost bacteria and microorganism
contaminated our skin surface
Sometimes several chemical is added (hexachlorofen,
phenol, carbanilide etc.)
PHENOL AND ITS RELATED
COMPOUNDS
Phenol causes denaturation of protein. Phenol is
first antiseptic that applied as spray by Lister
(1867) on his surgery. Concentration of 1 2%
is needed for antimicrobe activity, while
concentration of 5% could irritate tissue
Other derivate of phenol like: resorcinol, thymol,
and hexylresorcinol is used to antiseptic in past
time. Several chlorinated phenol is preferred
PRESENTATION
Benzalkonium (Zephiran)
Topical : concentrate 17%, solution
15% and sol 1 : 750
Chlorhexidin gluconate (Hibiclens,
Hibistat)
Topical : cleansing 2,4%
Hexachlorophen (pHisiHex,
Septisol)
Topical : liquid of 3%
Iodium aquaeus (Lugols solution)
Topical : 2 5% water solution
Iodium tincture
Topical : 2 - 5% solution
Merbromin (Mercurochrome)
Topical : sol 2%
Nitrofurazon (Furazin)
Topical : sol, ointment dan cream 10%
Oxychlorocen natrium (Clorpactin)
Topical : 2,5 g flour for irigation sol,
drops or cleansing
Povidon iodium (Betadin)
Topical; sol, aerosol, ointment
Silver protein (Argyrol 10% Sol)
Topical : Sol 10%
Thymerosal (Merthiolate, Mersol)
Topical : 1 : 1000 tincture and solution