Antiseptic(or antiseptics) are agents that are used for antimicrobial effects on the skin and mucous membranes. Unlike antiseptics, disinfectants agents (or disinfectants) are used to destroy microorganisms at various objects external environment(surgical instruments, utensils, operating room walls, water disinfection, bed linen, clothes, etc., etc.). Thus, the fundamental difference between antiseptics and disinfection lies in the answer to the question “what are we treating?”

Taking into account the above definitions, it becomes clear that the same substance can well be used both as an antiseptic and as a disinfectant (solution ethyl alcohol you can treat your hands, or you can dip a scalpel into it).

Antiseptics can be preventive(hand treatment, treatment of fresh wounds to prevent infection, skin treatment before surgery, etc.) and therapeutic(treatment of already infected wounds and mucous membranes).

We have repeatedly emphasized the fact that the local use of chemotherapeutic agents often does not allow the creation of a high concentration of an antimicrobial substance, which is a determining factor in the mechanism of formation of antibiotic resistance. Confirmation of this can be observed at every step: the same famous solution of furatsilin, which is currently practically ineffective against most actual bacteria.

The fundamental feature of a good modern antiseptic is that, firstly, it has a very wide range microbicidal action (antiviral, antifungal, and antibacterial) and, secondly, it is used specifically as an antiseptic (disinfectant), but in no other way (not used systemically).

It is obvious that the skin is more resistant to the damaging effects of chemicals (of course, in comparison with oral and parenteral administration), which makes it possible to create fairly high concentrations of a chemotherapeutic agent with minimal risk development of microbial resistance. All this creates the preconditions not only for effective prevention, but also to effective treatment, which often makes it possible to do without, for example, the use of antibiotics.

The number of drugs used for antiseptics and disinfection is huge, but we will allow ourselves only a brief overview of the main and most commonly used drugs, focusing on medicines, the need for which arises during therapeutic and prophylactic use at home.

All antiseptics and disinfectants can be divided into three main groups :

• inorganic substances- acids, alkalis, peroxides, individual chemical elements(bromine, iodine, copper, mercury, silver, chlorine, zinc) and their derivatives (again inorganic);
• organic substances- aldehydes, derivatives of alcohols and phenols, acids and alkalis, nitrofurans, quinolines, dyes and much more. The main thing is synthetic substances of organic nature;
• bioorganic substances- drugs natural origin, i.e. obtained from actually existing biological objects (plant or animal raw materials, fungi, lichens).

Halogens and their derivatives

They are represented mainly by preparations based on chlorine and iodine.
To begin with, about chlorine…
Widely known (due to effectiveness and low cost) chloramine , which in solutions of different concentrations can be used both as an antiseptic and as a disinfectant.

• pantocide . Available in tablets and can be used to disinfect water (1 tablet per 0.5-0.75 l).
• chlorhexidine . Presented in a huge number of dosage forms: solutions (aqueous and alcoholic) in a wide variety of concentrations, aerosols, ointments, gels (including special dental ones), creams, emulsions, etc. In combination with other substances, it is included in some tablets used for resorption in the oral cavity for stomatitis, pharyngitis, etc. Chlorhexidine can be used as a mouth rinse, in the bladder, on wounds and on intact skin. In most cases well tolerated age restrictions No. It is not recommended to use it together with iodine preparations - skin irritation often occurs;

• biclotymol . It is used mainly for diseases of the oral cavity. Available in the form of a spray and lozenges. Contraindicated for children under 6 years of age.

Widely known as an antiseptic 5% alcohol solution of iodine . Use is advisable for treating wound edges (but not the wound surface!), as well as small cuts and injections (when the wound surface is practically absent).

The use of iodine solutions should be treated with caution due to two circumstances. Firstly, molecular iodine from the surface of the skin is able to be partially absorbed, reach the systemic bloodstream and create concentrations that inhibit the function of thyroid gland. Secondly, a 5% iodine solution quite often causes skin irritation, and the younger the child, the higher the risk of irritation.

Taking into account the two described circumstances, a standard 5% iodine solution is not recommended for use in children under 5 years of age. Some guidelines allow its limited use in children aged 1-5 years in diluted form (2-3% solution). Nevertheless, everyone is unanimous in the aspect that children of the first year of life cannot use a 5% iodine solution in any form.

At the same time, there are numerous iodine-containing antiseptics and disinfectants that are superior in their properties to the standard 5% solution - more effective and safe. These drugs, for the most part, if they irritate the skin, do so moderately; they exhibit a more intense and long-lasting antiseptic effect. Nevertheless systemic effects iodine are possible, so caution should be exercised and instructions strictly followed.

In particular, when using tools such as Iodinol And iodonate (solutions) molecular iodine is also formed, which can be absorbed into the blood.

Preparations that combine iodine with special substance- polyvinylpyrrolidone.

Iodine bound to polyvinylpyrrolidone , loses its irritating effect on the skin and mucous membranes, and in addition is slowly released, which determines the long-term effect of the drug. The drugs are available in solutions, ointments, vaginal suppositories, and aerosols.

Povidone-Iodine

Povidone-Iodine

Aquazan, solution Betadine, solution, ointment, liquid soap, vaginal suppositories Betadine, solution, vaginal suppositories Brownodin B. Brown, solution, ointment Vokadin, solution, ointment, vaginal tablets Yod-Ka, solution Iodixol, spray Iodobak, solution Iodovidone solution Iodoxide, vaginal suppositories Iodosept, vaginal suppositories Iodoflex, solution Octasept, solution, aerosol Povidin-LH, vaginal suppositories Povidone-Iodine, solution, ointment, foam solution Povisept, solution, cream Polyiodine, solution Early stop, ointment

A conversation about iodine preparations would be incomplete without mentioning solution Lugol .

In just a little while, Lugol's solution will turn 200 years old - the French doctor Jean Lugol proposed it in 1829 for the treatment of tuberculosis! The composition of Lugol's solution includes iodine (1 part), potassium iodide (2 parts) and water (17 parts). Lugol's solution in glycerin is also available.

Lugol's solution is still actively used (by some doctors in countries with developing healthcare) to treat the mucous membranes of the oropharynx for tonsillitis and pharyngitis. Modern medicine considers such treatment unjustified (especially in children), primarily because the therapeutic effectiveness is in doubt, and the significant and potentially dangerous intake of iodine into the systemic bloodstream, on the contrary, does not raise any doubts.

And lastly, to complete the conversation about iodine preparations. The irritating effect of iodine on the skin is often used to implement the so-called. distracting procedures. The latter, in most cases, is the process of applying drawings to the skin using a 5% iodine solution - most often drawing iodine nets (on the back with acute respiratory infections, on the buttocks after injections, etc.). The mentioned method of “treatment”, firstly, has nothing to do with civilized medicine, secondly, it obviously carries a risk associated with excessive intake of iodine into the body, and, thirdly, it represents effective example calming psychotherapy for those who, in fact, draw.

Oxidizing agents, acids, aldehydes and alcohols

Oxidizing agents are capable of releasing atomic oxygen, which in turn has a detrimental effect on microorganisms. Two oxidizing agents are widely known and actively used (although no one thinks about the fact that they are oxidizing agents): hydrogen peroxide and potassium permanganate (popularly known as potassium permanganate).

Peroxide hydrogen is produced mainly in the form of a 3% solution. Used as an antiseptic for treating skin and mucous membranes. It is also used as a hemostatic agent. Modern recommendations consider it appropriate to treat the edges of the wound, but do not provide for contact of hydrogen peroxide with the wound surface: the antiseptic effect is beyond doubt, but it has also been proven that such treatment negatively affects the healing time. Regarding the timing of stopping bleeding: with intense bleeding, hydrogen peroxide is ineffective, with moderate bleeding, pressure on the wound is enough to stop it.

In recent pseudoscientific literature, a lot of advice has appeared on the non-standard (to put it mildly) use of hydrogen peroxide - it is used orally and even administered intravenously for the purpose of rejuvenating the body and total recovery. The authors of the recommendations very convincingly (for those without medical education) describe the advantages of such methods, but their scientific justification does not exist. It is not our task to debunk myths, but we would like to earnestly ask parents not to use hydrogen peroxide in an unconventional way at least in relation to children (especially since they will certainly do without rejuvenation).

Hydroperite is a compound of hydrogen peroxide and urea. It is produced in tablets, which are dissolved in water before use - the resulting solution is identical in its properties to hydrogen peroxide. Many parents are convinced that a tablet of hydroperite per glass of water is the “correct” solution of hydrogen peroxide.

Let us clarify: a solution corresponding to 3% peroxide is 1 tablet of 0.5 g per 5 ml of water! There are also tablets of 0.75 and 1.5 g (it is clear that 1.5 g is per 15 ml of water).

Potassium permanganate . It appears as red-violet crystals (sometimes powder). Let's dissolve well in water. Pharmacological guidelines recommend the use of potassium permanganate for washing wounds, rinsing the mouth, and douching. Concentrated solutions (2-5%) are used to lubricate ulcerative surfaces.

Most parents believe that the main goal home use potassium permanganate - disinfection of water prepared for bathing a baby. In fact, this is far from the case. The minimum concentration of potassium permanganate that has antiseptic activity is a 0.01% solution. At the same time, the standard recommended disinfectant concentrations are 0.1% and higher.

Let us translate for those who are not particularly good at mathematics: a 0.01% solution is 1 g per 10 liters of water, 0.1% is, respectively, 10 g per 10 liters!

Thus, by adding a “gramule” of potassium permanganate to the water and making it (the water) pale pink in color, parents are not disinfecting anything, but are just putting a tick on their own conscience - our baby, they say, is now in no danger.

Bornaya acid . Available in the form of powder, solutions of different concentrations, ointments. Included in some combined agents for external use (together with zinc, petroleum jelly, etc.).

A 2% aqueous solution is used for conjunctivitis, alcohol solutions of different concentrations are prescribed for otitis media (dropped into ear canal or moisten the turundas).

Currently, the use of boric acid is limited in many countries, since numerous side effects associated with the toxic effects of the drug have been identified - vomiting, diarrhea, rash, headache, seizures, kidney damage. All this more often occurs with an overdose (treatment of large areas of skin, for example) or long-term use. However, the risk is always present, which is why most doctors consider boric acid to be an outdated and unsafe drug. In any case, the drug is contraindicated during pregnancy, breastfeeding and children in the first year of life.

Formaldehyde (a common synonym is formaldehyde). Widely used in medical institutions, is part of some combination disinfectants. Has nothing to do with outpatient pediatrics.

Ethyl alcohol . As an antiseptic, it is most advisable to use a 70% solution. Can be used to treat hands and skin (around the wound, before injections). Even from the surface of intact skin it enters the systemic bloodstream. Inhalation of alcohol vapor is accompanied by a similar effect. Exactly In children, alcohol poisoning is especially dangerous due to severe respiratory depression.

Use as irritant(compresses, rubbing, lotions, etc.) and to combat elevated temperature body (wiping the skin) in children is risky and is currently not recommended (more often strictly prohibited) by health authorities in most civilized countries.

Metal salts and dyes

Protargol (silver proteinate). Used in the form of a 1-5% solution as an antiseptic: lubrication of mucous membranes respiratory tract, bladder lavage and urethra, eye drops.

Currently pharmacological reference books Protargol is considered an outdated remedy with very moderate effectiveness, completely incomparable with that of modern antibacterial agents. Nevertheless, in some regions protargol is still widely used by doctors who believe in its effectiveness. The frequency of use is largely explained by the psychotherapeutic effect - the very phrase “silver treatment” has a healing effect.

Collargol (colloidal silver). In solutions of different concentrations (0.2-5%) it is used for the same indications and with the same moderate results as protargol.

Zinc sulfate . In the form of a 0.25% solution, it is sometimes used as an antiseptic for conjunctivitis (eye drops). However, it is more often used in tablets to treat certain diseases associated with zinc deficiency in the body.

Zinc oxide . Actively used in the treatment of many skin diseases. It is used both independently and in combination with other drugs. Included in powders, ointments, pastes, liniments.

Diamond green (popular name - brilliant green). A widely known and equally actively used ineffective antiseptic. The breadth of application, however, is limited to the territory of the former Soviet Union. Available in the form of alcohol solutions (1 and 2%), as well as in the form of pencils.

Methylene blue . Available in both alcohol and aqueous solutions. Alcohol solutions (1-3%) are used to treat the skin for antiseptic purposes, and cavities (for example, the bladder) are washed with water solutions. The effectiveness of application as an external agent is equivalent to that of brilliant green.

Methylene blue is used not only as an antiseptic. Its solutions are very effective against certain poisonings: hydrogen sulfide, carbon monoxide, cyanides (injected intravenously during treatment).

Magenta . Dye, aqueous solutions of bright red color. It is not used independently, but is part of some combined antiseptics, in particular fucorcin (a combination of fuchsin, boric acid, phenol, acetone, resorcinol and ethanol). Indications for the use of fucorcin are fungal and pustular skin diseases, abrasions, cracks, etc.

The fucorcin solution (thanks to fuchsin) also has bright red color. Thus, parents are given the opportunity to widely use a wide variety of ineffective, but completely safe dyes, which means, in accordance with their artistic taste, they can paint their children green, blue and red.

Bioorganic substances

Chlorophyllipt . Possessing antibacterial activity the drug is a mixture of chlorophylls obtained from eucalyptus leaves. In some situations, it is capable of exhibiting bactericidal activity against antibiotic-resistant bacteria. For local application use oil and alcohol solutions of varying concentrations.

During use, quite severe allergic reactions are possible.

Sodium usinate . Contains usnic acid, which is isolated from a special type of lichen. Has moderate antibacterial activity. Available in the form of an alcohol solution, as well as solutions in castor oil And fir balsam. The latter is of some pediatric interest - many note its effectiveness in treating cracked nipples in nursing mothers.

Lysozyme . One of the most important components immune defense. Enzyme. Derived from protein chicken eggs. Wipes moistened with lysozyme solution are used in the treatment of purulent wounds, burns, and frostbite. Also used in the form eye drops.

Ectericide . Transparent yellow oily liquid with specific smell fish oil(from it, in fact, the ectericide is obtained).

Has antibacterial activity. Used to treat festering wounds, burns, ulcers, fistulas, etc.: wash, apply wet wipes. It is often used in the form of nasal drops - mainly for prolonged runny nose of an infectious nature.

Flowers marigold . A common synonym is calendula flowers. An infusion of flowers is used as an antiseptic for inflammatory diseases oral cavity. Calendula tincture in 70% ethanol is also available. Indications, precautions and meaning of use are the same as for 70% ethyl alcohol.

Other antiseptics and disinfectants

Decamethoxin . Has antibacterial and antifungal effect. Available in the form of ear and eye drops, as well as in the form of tablets intended for the preparation of solutions. Used for the treatment of otitis and conjunctivitis, for rinsing with bacterial and fungal infections of the oral cavity, for lotions for skin diseases, for rinsing the bladder, etc.

Decamethoxin is well tolerated, there are no contraindications for use (except hypersensitivity) No.

Miramistin . A complete antiseptic - it is active against viruses, bacteria, fungi, and protozoa.

The main indication for use is the prevention of suppuration and treatment of purulent wounds. Used for otitis, conjunctivitis, sinusitis, and a wide variety of inflammatory processes oral cavity.

Available in solutions (usually 0.01%) and as a 0.5% ointment.

Ichthyol . It is almost impossible to explain what ichthyol is and where it comes from - the simplest available explanation looks something like this: “ichthyol is obtained from resins formed during the gasification and semi-coking of oil shale.” Ichthyol is a thick black liquid with a very specific odor. Has absolutely insignificant antiseptic properties. According to the behests of grandmothers who believe in its miraculous effectiveness, it is used in the form of an ointment for treatment various diseases skin. Not used by civilized medicine.

Octenidine (octenidine hydrochloride). Modern antiseptic wide spectrum of action. It does not penetrate into the systemic bloodstream even when treating wounds, which determines its uniquely low toxicity. It makes no sense to describe the indications for use - it can be used in almost all situations where an antiseptic effect is necessary (with the exception of dripping into the ear and rinsing the bladder). Rational as a means primary processing wounds (pricks, abrasions, cuts) at home.

Available in solution, in bottles with various attachments (for spraying, for insertion into the vagina).

Can be used in children of any age, during pregnancy and breastfeeding. In the latter case, if treatment of the nipples is necessary, care must be taken to ensure that the drug does not get into the child’s mouth.

In ready dosage forms octenidine is usually combined with phenoxyethanol(also an antiseptic, but with preservative properties).

Quaternary ammonium compounds. A group of widely used antiseptics and disinfectants. The most famous - benzalkonium chloride , which, in addition to its antimicrobial effect, also has spermicidal activity (i.e., the ability to kill sperm), and therefore is used as a contraceptive local action.

Benzalkonium chloride is included in many topical medications intended for wound treatment, absorption in the oral cavity, etc.

Benzalkonium chloride

Benzalkonium chloride

Benatex, vaginal gel, vaginal suppositories, vaginal tablets Virotek Intim, solution Virotek Clinic, solution Dettol spray Katamin AB, solution Katapola solution Katatcel, paste for external use Contratex, vaginal suppositories Line-bio, liquid Lizanin, solution Maxi-Dez, solution Micro 10+, solution Rokkal, solution Septustine, solution Spermatex, vaginal suppositories Pharmaginex, vaginal suppositories Pharmatex, vaginal cream, vaginal suppositories, tampons for intravaginal administration Erotex, vaginal suppositories

Another famous drug this group - cetrimide . Its combination with benzalkonium chloride is available in the form of a cream, indications for use are diaper rash, diaper dermatitis, burns.

(This publication is a fragment of the book by E. O. Komarovsky adapted to the format of the article

ANTISEPTIC AND DISINFECTANTS

Disinfectants– designed to destroy pathogens in the external environment, used to disinfect premises, patient clothing, care items, secretions, and medical instruments.

Antiseptics– used to destroy pathogens on the surface of the human body (skin, mucous membranes, wound surfaces).

Features of antiseptics and disinfectants:

the mechanism of action is mainly associated with protein coagulation

nature of action is bactericidal

antimicrobial spectrum is wide, there is no selectivity for certain microflora

microflora does not become addictive

toxicity is high, so the main use is local (rarely for resorptive purposes)

a) Chlorine preparations

In aqueous solutions they form hypochlorous acid (HClO), which decomposes in acidic and neutral environments to form atomic oxygen and chlorine. Oxygen oxidizes and coagulates microbial cell proteins, and chlorine replaces H + in the amino group, forming a chlorinated protein, which leads to disruption of the formation of H-bonds between polypeptide chains and disruption of the secondary structure of the protein. In an alkaline environment, hypochlorous acid dissociates to form a hypochloride ion (ClO –), which also has the properties of an oxidizing agent, but its antimicrobial activity is lower than that of atomic O and Cl. Therefore, as the pH increases, the effect of chlorine-containing antiseptics decreases. The antimicrobial activity of drugs is determined by the presence of active chlorine.

Chloramine B– a good antiseptic with a deodorizing effect. Contains 25-28% active chlorine. Does not irritate the skin. Used:

0.5 - 1% solution - treatment of hands, infected wounds

2-3% - processing of care items, patient secretions

5% - treatment of secretions of a tuberculosis patient

b) Iodine preparations

Elemental iodine has powerful bactericidal activity; it coagulates proteins, providing a powerful restorative effect.

Pharmacological effects of iodine:

antiseptic

antisyphilitic

antifungal

expectorant

anti-sclerotic (improves lipid metabolism)

antithyroid

absorbable

Alcohol solution of iodine used in the treatment of abrasions and scratches.

Iodinol used externally for chronic tosillitis, purulent otitis, trophic ulcers.

Biguanides.

Chlorhexidine acts on bacteria, fungi of the genus Candida, Trichomonas. Does not affect disputes. Used in solutions for treating the surgeon’s hands and the surgical field - 0.5% alcohol solution; for gingivitis, stomatitis, wound infections, in gynecological practice– 0.05% aqueous solution; for rinsing the bladder - 0.02% aqueous solution.

Oxidizing agents:

Hydrogen peroxide– upon contact with tissues, it decomposes in two ways:

1. H 2 O 2 peroxidase H 2 O + O (antimicrobial action (oxidation))

2. H 2 O 2 catalase H 2 + O 2 (mechanical cleansing of wounds)

As an antiseptic, the drug is not very active; its cleansing effect is mainly expressed due to foaming. Used for treating contaminated and purulent wounds, for rinsing the mouth for stomatitis, sore throats. It has a hemostatic effect (due to the activation of thromboplastin and mechanical clogging of small vessels; it is dangerous to wash the cavities (uterus, bladder) due to the possibility of embolism). Preparations: diluted hydrogen peroxide solution (3%), perhydrol (concentrated solution).

Potassium permanganate– as an antiseptic it exhibits greater activity compared to hydrogen peroxide, because when it decomposes, atomic oxygen is released. It also has deodorizing properties. Drug solutions

(0.01-0.1%) is used for washing wounds, rinsing the mouth and throat, for douching, and washing the urethra. Oxidizes alkaloids and some toxins, therefore it is used for gastric lavage in cases of alkaloid poisoning and foodborne diseases. Due to manganese oxide, it has an astringent and cauterizing effect, which is used to treat ulcers and burns (2-5% solution).

Metal compounds: these are general cellular poisons, they bind thiol groups (SH groups) of enzymes and form albuminates with proteins. If the albuminate is dense, the effect is astringent and bacteriostatic, if it is loose, the effect is cauterizing and bactericidal.

According to the degree of solubility of albuminates, metals are arranged as follows:

Schmiedeberg series

AlPb ZnCuAgHg

Solubility

Antimicrobial action

Silver nitrate– low concentrations (up to 2%) have an antimicrobial effect, in higher concentrations (5-10%) it acts as a cauterizing agent. Used in low concentrations for infectious diseases eyes (trachoma, conjunctivitis), and in higher cases - in the treatment of skin ulcers, erosions, cracks, as well as for the removal of excess granulations and warts.

Protargol, collargol– organic silver preparations.

Zinc sulfate And copper sulfate as antiseptics and astringents used in solutions of 0.1-0.25% for conjunctivitis, laryngitis, urethritis.

Mercury dichloride(sublimate) in solutions of 1:1000 is used to disinfect linen and patient care items. Highly toxic.

Mercury oxide yellow– less toxic, used as an antiseptic for conjunctivitis and blepharitis.

Acids and alkalis: interact with proteins, the nature of the action depends on the concentration of the substance.

Weak acids have a reversible astringent effect (form gels in the surface layers). Strong acids deeply denature proteins, have a cauterizing effect, and dehydrate tissues (dry necrosis - coagulation).

Weak alkalis soften the epidermis, dissolve mucus, and reduce its viscosity. Strong alkalis cause tissue necrosis with liquefaction (liquefaction necrosis) and penetrate deeply into tissues (deep burns).

Boric acid in the form of a 2% solution it is used in ophthalmic practice, 3% - for dermatitis, pyoderma.

Ammonia solution(ammonia) has antiseptic and cleaning properties. Used for hand washing medical personnel, for processing premises.

Aldehydes and alcohols:

Formaldehyde– used in the form of a 40% solution (formalin). Acts on bacteria, fungi, viruses. Coagulates proteins and has a powerful antimicrobial effect. It has a tanning effect and removes water from the surface layers of tissues. Used for hand treatment, disinfection of instruments, for excessive sweating (0.5 - 1% solution), for preserving tissues, histological preparations, formaldehyde vapor - for disinfecting clothes.

Ethanol 70-95% denatures proteins and has a bactericidal effect. A concentration of 70% is used to treat the surgeon’s hands and the patient’s skin. In this concentration, ethyl alcohol has a deeper antiseptic effect on the skin (penetrates the ducts of the sebaceous and sweat glands). In concentrations of 90-95% they are used for disinfection - disinfection surgical instruments.

Detergents: These are cationic soaps, substances with high surface activity. They accumulate on the cell membrane of a microorganism, change surface tension, increase permeability, which leads to swelling and death of the microorganism.

Cetylpyridinium chloride as part of the drug "Zerigel" used for hand treatment.

Aromatic antiseptics:

Phenol(carbolic acid) is the oldest antiseptic, a standard for assessing the antiseptic activity of other drugs (phenol coefficient).

Phenol in small doses has a bacteriostatic effect, in large doses it has a bactericidal effect. It causes deep denaturation of the cytoplasmic protein of the microbial cell. It acts mainly on vegetative forms of bacteria and fungi and little on spores. When interacting with proteins, it does not form a strong bond and can react with several protein molecules, i.e. the presence of proteins does not reduce the antiseptic activity of phenol, so it is rational to use it to treat patient secretions. Used in the form of 1-3% solutions for disinfecting linen, care items, and instruments. Has a pronounced irritating, local anesthetic effect; in a concentration of 2% and higher – cauterizing effect. Possible poisoning if absorbed through the skin.

Birch tar contains phenol and its derivatives. It has antiseptic, insecticidal, keratoplastic and keratolytic effects. Used to treat a number of skin diseases and scabies.

Dyes: methylene blue, brilliant green, ethacridine lactate. They affect mainly gram-positive flora and disrupt the enzymatic properties of microorganisms.

Diamond Green- the most active dye, used in the form of 1-2% aqueous or alcohol solutions to lubricate the skin with pyoderma and the edges of the eyelids with blepharitis.

Methylene blue– as an antiseptic inferior to other dyes. Used for cystitis, urethritis - 0.02%, ulcerative stomatitis - 0.5-1% aqueous solution, for pyoderma, burns - 1-3% alcohol solution. Used to study the functional abilities of the kidneys. It is interesting from a toxicological point of view - it has powerful redox properties, can play the role of an acceptor and donor of H +, and is used as an antidote for poisoning with cyanides and nitrites (intravenous 1% aqueous solution).

Ethacridine(rivanol) is used in solutions of 0.05-0.1% for the treatment of wounds, washing cavities during purulent processes. To treat skin diseases, 3% ointment is used.

Nitrofurans.

Used as an antiseptic furatsilin, effective against gram-positive and gram-negative bacteria. An aqueous solution of furatsilin 0.02% is used to rinse the mouth and throat for stomatitis, sore throats, and for washing purulent wounds.

Antiseptics(antiseptics) are substances that destroy microorganisms or delay their development.

Antiseptics are active to one degree or another against all microorganisms, that is, unlike chemotherapeutic agents, they do not have selectivity of action. The action of antiseptics, leading to a delay in the development or reproduction of microorganisms, is called bacteriostatic, leading to their death. Last effect can be called a disinfectant. Some antiseptics can have both bacteriostatic and bactericidal effects, which depends on their concentration and duration of action, the sensitivity of microorganisms to them, temperature, and the presence of organic substances in the environment (pus, blood weaken the effect of some antiseptics).

Antiseptics are very different in nature. The following groups are distinguished. I. Halides: , iodine, . II. Oxidizing agents: potassium permanganate, . III. Acids: , salicylic. IV. : . V. Connections heavy metals: , (xeroform), copper, . VI. (ethyl, etc.). VII. : , lysoform, . VIII. : , lysol, phenol. IX. Tars, resins, petroleum products, mineral oils, synthetic, preparations (tar, refined naftalan oil,). X. Dyes: , methylene blue, . XI. Nitrofuran derivatives: . XII. 8-hydroxycholine derivatives: . XIII. Surfactants, or detergents: diocide. They are also used as antiseptics for external use () and.

To characterize the antimicrobial activity of antiseptics, the phenol coefficient is used, which shows the strength of the antimicrobial action this tool compared to phenol.

Antiseptics are used topically in the treatment of infected and long-term non-healing wounds or ulcers, phlegmon, mastitis, joint injuries, diseases of the mucous membranes, for washing the bladder, urethra, as well as for rooms, linen, objects, surgeon's hands, instruments, disinfection of secretions . Antiseptics are usually not used to treat general infections.

Contraindications for use, as well as a description of individual antiseptics - see the articles on the names of the drugs [for example, etc.].

Antiseptics are antimicrobial substances used for local action in the treatment of purulent, inflammatory and septic processes (infected and long-term non-healing wounds or ulcers, bedsores, abscesses, phlegmon, mastitis, joint injuries, pyoderma, diseases of the mucous membranes), as well as for disinfection premises, linen, patient care items, surgeon's hands, instruments, disinfection of secretions. These substances are usually not used to treat general infections.

Antiseptics act germistically, and in high concentrations they exhibit a germicidal effect. Therefore, some antiseptics can be used as disinfectants (see). In addition, antiseptics are used for preservation medicines And food products. The antimicrobial activity of antiseptics is expressed using the phenol coefficient - the ratio of the bactericidal concentration of phenol to the bactericidal concentration of a given antiseptic.

The degree of effectiveness of antiseptics depends on a number of conditions: the sensitivity of the microorganism to it, the concentration of the antiseptic, the solvent in which it is used, temperature, and the time of exposure to the drug. Many antiseptics lose activity to a greater or lesser extent in the presence of proteins, so it is advisable to use them only after cleansing infected surfaces of exudate. Antiseptics act on all types of bacteria and other microorganisms, without showing the selectivity inherent in chemotherapeutic substances. Many antiseptics can damage living cells of the macroorganism. As a result, the assessment of antiseptics necessarily includes determining their toxicity to humans and animals using the “toxicity index” - the ratio between the minimum concentration of the drug that causes the death of the test microorganism within 10 minutes, and maximum concentration the same drug, which does not suppress the growth of chicken embryo tissue culture. For medical practice, the most valuable are antiseptics, which, other things being equal, have the least toxicity.

Antiseptics are diverse in nature. They can be divided into the following groups. I. Halides: chlorine gas, bleach, chloramines, pantocid, antiformin, iodine, iodoform. II. Oxidizing agents: hydrogen peroxide, potassium permanganate, bertholet's salt (potassium hypochlorite). III. Acids: sulfuric, chromic, boric, acetic, trichloroacetic, undecylenic, benzoic, salicylic, mandelic and some others. IV. Alkalis: calcium oxide, ammonia, soda, borax. V. Compounds of heavy metals: 1) mercury; 2) silver; 3) aluminum - basic aluminum acetate (Burov's liquid), alum; 4) lead - basic lead acetate (lead water); 5) bismuth - xeroform, dermatol, basic bismuth nitrate; 6) copper - copper sulfate, copper citrate; 7) zinc - zinc sulfate, zinc oxide. VI. Alcohols: ethyl, isopropyl, trichloroisobutyl, some glycols. VII. Aldehydes: formaldehyde, hexamethylenetetramine (urotropine). VIII. Phenols: phenol, or carbolic acid, cresol, creolin, parachlorophenol, pentachlorophenol, hexachlorophen, resorcinol, thymol, tricresol, phenyl salicylate (salol), benzonaphthol. IX. Products of dry distillation of organic materials: various resins and tars, ichthyol, albichtol. X. Dyes: brilliant green, rivanol, trypaflavin, methylene blue and gentian violet. XI. Nitrofuran derivatives: furatsilin, furadonnn, furazolpdon. XII. 8-hydroxyquinoline derivatives: quinozol, yatrene. XIII. Surfactants, or detergents. There are cationic, anionic and nonionic detergents. Cationic detergents (for example, cetylpyridinium bromide) are most active. XIV. Antibiotics (see): gramicidin, neomycin, microcide, usnic acid. XV. Phytoncides (see): preparations of garlic, onion, St. John's wort, burnet, eucalyptus, etc.

The mechanism of action of antiseptics is different and is determined by their chemical and physical and chemical properties. The antimicrobial effect of acids, alkalis and salts depends on the degree of their dissociation: the more a compound dissociates, the greater its activity. Alkalis hydrolyze proteins, saponify fats, and break down carbohydrates of microbial cells. The effect of salts is also associated with changes osmotic pressure and impaired permeability of cell membranes. The effect of antiseptics that lower surface tension (soaps, detergents) is also associated with changes in the permeability of bacterial membranes. The effect of heavy metal salts is explained by their ability to bind sulfhydryl groups of substances in the bacterial cell. Antiseptic effect formaldehyde is due to its ability to denature proteins. Compounds of the phenol group have detergent properties and are capable of denaturing proteins. Oxidizing agents cause the death of microbial cells as a result of their oxidation components. The mechanism of action of chlorine and chlorine-containing compounds is associated with the formation of hypochlorous acid (HClO), which acts both as an oxidizing agent, releasing oxygen, and as a means of chlorinating the amino and imino groups of proteins and other substances that make up microorganisms. The antimicrobial effect of dyes is associated with their ability to selectively react with certain acidic or basic groups of substances in bacterial cells with the formation of sparingly soluble weakly ionizing complexes. The antimicrobial effect of nitrofuran derivatives is due to the presence of an aromatic nitro group in their molecule. Antiseptics inhibit the activity of many bacterial enzymes. For example, the bactericidal effect of antiseptics is closely related to their ability to inhibit the dehydrase activity of bacteria. Under the influence of antiseptics, the process of cell division stops and morphological changes occur, accompanied by a violation cellular structure. Selected antiseptics - see relevant articles.

IN medical practice The most relevant and widespread measure is the disinfection of premises, surgical instruments and directly individual parts of the human body. This implies using special means. In this article we will provide detailed information about what an antiseptic is.

Definition of antimicrobial interventions

Methods of sterilization and disinfection play a fundamental role when performing various medical procedures. Knowledge about this constitutes the main sections in training when receiving medical education. To understand what an antiseptic is, you first need to understand what antiseptics and aseptics are.

• Asepsis is the totality preventive measures preventing the emergence of pathogenic microorganisms. Thanks to them, the patient receives reliable protection from the introduction of infectious pathogens into open wounds, as well as organs, tissues and other body cavities. Asepsis is mandatory when diagnosing, surgical operations and microbiological research.
• Antiseptics is the complex suppression or destruction of organisms that pose a potential danger to the patient’s health on mucous membranes, damaged skin and cavities.

There are two sources of infection:

• Exogenous. The reason for the penetration of microbes is external factors. When hit pathogens from outside medical workers resort to asepsis.
• Endogenous. The infection is located in the human body. In this case, the main role is given to antiseptics.

Antiseptics

Since we are going to dwell on the means by which treatment is carried out aimed at destroying bacteria, it would be appropriate to learn about the types of antiseptics.

Preventive. Consists of performing the following actions:

• Treatment of fresh open wounds.
• Hand hygiene.
• Disinfection of the operating surface.
• Preventative techniques for newborns, for example, treatment of the umbilical wound.
• Cleaning surgeons' hands before surgery.
• Antiseptic for mucous membranes and skin infections.

Therapeutic. Antiseptics in medicine are used for their intended purpose. For each type therapeutic measure I have my own means. Here is their list:

• Biological (products developed on the basis of antagonist bacteria and bacteriophages).
• Chemical antiseptics (bacteriostatic and bactericidal drugs).
• Mechanical antiseptics (use of solutions for initial treatment of wounds and after removal of infected tissue areas).
• Physical method (sorption, drainage, surgical treatment).
• Combined.

The last-mentioned type of antiseptic is most often used in medical practice for the reason that one method of treatment is not enough. What is antiseptic in general? Let's see how this happens using the example of treating a fresh wound.

Along with surgical techniques (chemical and mechanical), biological antiseptics are carried out. To have a direct effect on the pathogen, antitetanus serum or antibiotics. After first aid, physical antiseptics are immediately prescribed, which involves physiotherapeutic procedures.

The role of bactericidal agents

It is logical that in order to carry out antibacterial treatments, substances that can defeat harmful bacteria must be found. An antiseptic is a product that prevents decomposition processes and destroys putrefactive microorganisms. Drugs developed for this purpose are classified according to their therapeutic effects:

• Bacteriostatics inhibit the growth of infectious pathogens.
• Germicidals destroy pathogenic microorganisms.
• Microbicides help destroy viral particles.
• Antibacterial agents prevent the growth of bacteria.

Action of antimicrobial agents

Such substances penetrate the cell walls of bacteria and damage their cell membranes. This either inhibits the metabolic processes of microorganisms or changes the permeability of their cell walls. Antiseptics are designed to inhibit or correct the growth of pathogenic microbes on living tissue areas. Thanks to them, the risk of infection and development of infection in people and animals is reduced.

When prescribing an antimicrobial drug, the causative agent of the disease is collected from the patient and its sensitivity to the drug is checked. When choosing an external antiseptic, the natural reaction of microbes at the site of application of the antibacterial liquid is recognized.

Belonging of antiseptics to a chemical group

Inorganic substances include alkalis, acids, and peroxides. Individual elements are also used here: chlorine, silver, copper, iodine, zinc, bromine, mercury.

The organic group of synthetic substances includes derivatives of phenols and alcohols, quinolines, alkalis, aldehynes, acids, nitrofurans and dyes.

Bioorganic antiseptics are products obtained from natural objects. Lichens, mushrooms and some plants can serve as biological raw materials.

Petroleum products, essential oils, tars and natural salts have also proven themselves as effective antiseptics.

All of the above chemical and biological substances act as medicines and can be used at home.

Chemicals popular in medicine

• Phenol is the most common agent used to treat surgeons' hands before surgical intervention. It is part of others antibacterial drugs. The product is capable of defeating viruses and is prescribed for rinsing oral cavity and throat. Phenol in powder form is used to treat infants' navels. In addition, it has an analgesic effect.
• Metal-containing compounds. Distinctive feature of these substances - selective and specific action. They have a toxic effect on bacteria, but are gentle on the human body. Because of these properties, they are used to treat sensitive organs. Mercury oxycyanide serves as a disinfectant. Optical instruments are treated with its solution. The eyes and mucous membranes are washed with silver nitrate.
• Halides. Alcohol tincture iodine is used as an antiseptic for skin before surgery and venipuncture. Wide Application Iodopyrone and iodonate are also found. Chloramine is an effective wound antiseptic because it contains active chlorine. Contaminated open areas are irrigated and washed with a sodium hypochlorite solution.
• Alkalis. From this group, ammonia solution (10%), sodium borate and ammonia are used for external treatment.
• Oxidizing agents. Rinse with hydrogen peroxide purulent wounds when dressing, and also make lotions and rinses. The solution does not penetrate into tissues and is used for decomposing cancerous tumors and bleeding of mucous membranes.
• Dyes. Brilliant green has a pronounced antimicrobial effect. In medicine, an antiseptic is used to combat Pseudomonas aeruginosa and staphylococcus. "Zelenka" cleanses purulent skin lesions, abrasions, oral mucosa, and superficial wounds well.
• Aldehyde compounds. Water solution formaldehyde (40%) is used to disinfect medical instruments, gloves, and drains. A weak solution (4%) is used to treat patient care items. Dry formaldehyde powder is used to sterilize optical instruments. It is capable of destroying bacteria and their spores within 5 hours.
• Acids. Boric acid solution prevents the growth and reproduction of many types of bacteria. Used to treat ulcers, wounds and mouth rinses.

The best remedy

During the discussion, we found out that doctors and their patients have many drugs at their disposal, each of which has a specific effect on bacteria. It is not possible to say that any of them is the most effective. We will try to highlight several criteria by which the best antiseptic is determined, according to its qualities. Firstly, a worthy product has either a good bactericidal effect, aimed at the death of microorganisms, or a bacteriostatic effect, helping to stop their reproduction. Secondly, it must be environmentally friendly and not have side effects on the human body. Thirdly, a drug is considered high quality if it has a wide range of positive therapeutic actions. It is also necessary to take into account whether the antiseptic will dissolve in lipids. The antimicrobial activity of the drug should not decrease during periods of body resistance, for example, in the presence of physiological and pathological substrates.

Important factors when choosing a product are the price and the guarantee of the safety of its antibacterial properties.

Drugs

Products in spray form are considered very convenient to use. Antiseptics of this type do not create unnecessary difficulties when applying them. Some drugs are commercially available large containers, which allows the use of a spray bottle. The most common medications include the following: “Chimetic”, “Panthenol”, “Eco Breeze”, “Octenisept”, “BioLong”, “Desisprey”, “Combi Liquid”, “Medonica”.

Antiseptics in ointment form are presented the following drugs: “Hexicon”, “Rescuer”, “Betadine”, “Levomikol”. And also ointments: salicylic-zinc, boric, tetracycline and ichthyol.

It is important to know that many external antiseptics contain antibiotics that can cause allergies. This must be taken into account when choosing a drug.

Natural antiseptics

Many medicinal herbs have a disinfecting effect. The series has good bactericidal properties, tangerine oil, aloe vera, knotweed, lime, thyme. They are used in folk medicine, as well as in the development of pharmaceuticals.

• Pharmacy tinctures: calendula, chamomile, eucalyptus leaves.
• Oils: juniper, frankincense, eucalyptus, lime and tea tree.

Buckthorn decoction helps in the treatment of boils and eczema. Flax seeds are used for oral ulcers.

Other Applications

It was found that recently bacteria have adapted to traditional methods disinfection, and their reproduction has accelerated significantly. To prevent fungal and viral infections, hairdressing salons use high-quality chemicals. Below is short description some of them.

Antiseptic spray "Bacillon AF" is active against standard viruses. Used for express processing of surfaces and tools. This product should be used with caution as it dries out the skin and causes flaking. Composition: ethanol (4.7%), propanol-1 (45%), glutoraldehyde (45%), propanol-2 (25%).

"Aerodesin". Alcohol-containing spray is intended for an accelerated processing method. After irrigating the items, leave the product on the surface for about 30 seconds. When used for a long time, plaque appears on instruments gray. Composition: didecyldimethylammonium chloride (0.25%), protanol-1 (32.5), ethanol (18%). According to the instructions, the antiseptics mentioned above are not used for treating medical instruments.

The latest innovation is spray-on hand sanitizers. They can be used in any public places and on the street. As a rule, they come in bottles with a dispenser that is easy to carry.

Antiseptics are also widely used in construction. They protect wooden structures from the appearance of blue stains, cracks, insects, and serve as the main layer for painting. Antiseptic agents penetrate inside the wood and form a film on the surface that protects against future damage.

What is the difference between an antiseptic and a disinfectant?

Both antiseptics and disinfectants are cleaning agents. They are widely used not only in hospitals and other medical institutions, but also at home. Although the terms used to describe them are used interchangeably, it is important to know that there is a difference between them. This article compares antiseptics and disinfectants.

It should be remembered

It is known that overuse antibacterial products such as antiseptics and disinfectants leads to the emergence of multi-resistant strains of bacteria. If such products are not used in certain medical purposes, and in households, it is always preferable to properly observe the rules of personal and home hygiene (use regular soap, warm water and a simple cleaning product).

What are antiseptics?

Antiseptics are chemical substances, intended for application to living tissue, such as skin, to kill or inhibit the growth of pathogens. They help reduce the possible risk of infection, sepsis or other diseases. Moreover, antiseptics are used to cleanse the skin before cutting it for surgical purposes. These substances are also used to treat the surface of cuts or scrapes to kill germs that may have already entered the wound. They can also serve as antibacterial agent in cases where hand washing is not possible. Antiseptics are commonly found in mouth rinses, medicated creams, etc. Some examples of antiseptics include rubbing alcohol, iodine, boric acid, and hydrogen peroxide.

What are disinfectants?

Disinfectants are chemicals designed to be applied to nonliving objects or surfaces to kill or control the growth of microorganisms present on them. Disinfectants can be toxic and should never be applied to living tissue or skin. They are widely used in cleaning homes, bathrooms, kitchens and operating rooms, washing countertops, floors, etc. Some popular disinfectants include various alcohols, household bleach, aldehydes and oxidizing agents. There are many other disinfectants such as iodine, silver, etc., the use of which depends on the applicability. Ultraviolet light is also considered a disinfectant and is used when surfaces cannot be wetted. It also comes in handy in cases where frequent disinfection is required. In general, disinfectants should sterilize surfaces, but it has been noted that sometimes microorganisms develop resistance to them, and their use can only make the situation worse. This often necessitates the use of much more concentrated varieties.

Note: As you can see, iodine, as well as some other chemicals, is used both as an antiseptic and as a disinfectant. Whether it is classified as an antiseptic or disinfectant depends on the concentration in which it is used. Thus, a weak solution of iodine can be used as an antiseptic, and a more concentrated solution can be used as a disinfectant.

Method of action

It is known that both of these varieties antimicrobial agents act in a similar way. They destroy bacteria and other microorganisms by penetrating their cell walls, damaging cell membranes, interfering with their metabolism, or changing the permeability of their cell walls.

Differences

Antiseptics	Disinfectants
Place of application
Applied to living tissues such as skin.	Applied to inanimate objects or surfaces.
Action
Suppress or control the growth of pathogens on living tissues. Thus, they reduce the risk of developing infections and other diseases that develop in humans or animals.	Destroy microorganisms that are present on various surfaces and inanimate objects. In this way, objects that can serve as a means of transmitting germs are disinfected.
Toxicity
Less toxic and aggressive Safe for application to living tissues and does not cause damage.	Very toxic and aggressive Application to living tissue is unacceptable; it can cause serious damage.
Interactions
About interaction with others medical supplies not reported. However, should not be used in conjunction with other external creams, ointments or solutions.	May react with other common household chemicals. Disinfectants such as bleach can react with ammonia or vinegar to produce toxic gases.
Concentration
Low concentration Weaker solutions of chemicals are used. They have a relatively weak effect.	High concentration More concentrated solutions of chemicals are used. They have a relatively strong effect.
Application
Widely used in the production of mouth rinses, hand washes, eye washes, creams against fungal infections, as first aid products. medical care etc.	Widely used in the manufacture of medical and household cleaning products for kitchens, bathrooms, hospital rooms and floors, and other surfaces where germs may be present.

When considering the above comparative table It becomes clear that the key difference between these two types of antimicrobial agents is where they are applied. It is necessary to remember this point, since disinfectants incorrectly used to treat living tissue or skin can have a detrimental effect on them.