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Active Ingredient in
Disinfectants & antiseptics
(others)
Chemist. Saleh A. El-Taweel
Head of Drug Analysis Dept.
Public Health Lab
Ministry of Health
Introduction
During patient treatment, surfaces in equipment and
treatment rooms are likely to become contaminated with
saliva or by aerosol containing blood, saliva, or both.
Laboratory studies have shown that microorganisms
may survive on environmental
surfaces for varying periods.
Assume that if a surface has had contact with saliva,
blood, or other potentially infectious materials,
it contains live microorganisms.
Hospitals
Danger of healthcare-associated infections
Reduce health care costs
Patients more susceptible to infection
Pathogens more likely found in hospital setting
Feces, urine, respiratory droplets, bodily secretions
Instruments must be sterilized to avoid introducing
infection to deep tissues
Minimizing microbial population
very important
Microbial Control Methods
• Chlorhexidine
• Povidone iodine
• Acriflavinium
• Glutaraldehyde
Name
&
Trade
Name
Method
of
Analysis
Uses
The role of
the Public
Health
Laboratory
in infection
control
Chlorhexidine
Chlorhexidine is a cationic polybiguanide
(bisbiguanide). It is used primarily as its salts
(e.g., the dihydrochloride, diacetate and
digluconate).
Method Analysis of Chlorhexidine
Ultraviolet Spectrophtomtric method Aqueous acid at 245 nm
Aqueous alkaline pH:10 at 232, 253 nm
Limit conformity 95 – 105%
Reference : Clarke’s Analysis of Drugs and Poisons, 40TH
Uses of Chlorhexidine
Chlorhexidine is used as low-level disinfectants
(disinfection of the skin and hands),
Cosmetics (additive to creams, toothpaste,
deodorants & antiperspirants).
Pharmaceutical products (preservative in eye
drops, active substance in wound dressings and
antiseptic mouthwashes).
Preparing skin for surgery
Chlorhexidine
At moderate to high concentrations, it is
bactericidal for both gram-positive and
gram-negative bacteria but inactive against
spores
low toxicity, rapid action
Povidone iodine
Povidone-iodine (PVP-I), brand name Wokadine and
Betadine. It contains from 9.0% to 12.0% available
iodine.
This unique complex was discovered at the Industrial
Toxicology Laboratories in Philadelphia by H. A.
Shelanski and M. V. Shelanski
It was first sold in 1955, and has since become the
universally preferred iodine antiseptic.
Method Analysis of Povidone Iodine
Iodometric titration to determine uvailable content of Iodine
Titrate sample with 0.02M Sodium thiosulphate
Limite conformity of Iodine 0.85 – 1.20 % w/v
Referance : Briticsh Pharmacopeia
Uses of Povidone iodine
Povidone-iodine is an iodophore that is used as a low-level disinfectant & antiseptic
Uses of Povidone iodine
It’s mainly for the treatment of contaminated
wounds and pre-operative preparation of the skin
and mucous membranes as well as for the
disinfection of equipment.
Solutions of povidone-iodine gradually release
iodine to exert an effect against bacteria, fungi,
viruses, protozoa, cysts, and spores.
Acriflavinium chloride
Acriflavine It has the form of an orange or brown
powder.
Acriflavine was developed in 1912 by Paul Ehrlich, a
German medical researcher and was used during the
First World War against sleeping sickness.
Method Analysis of Acriflavinium
Ultraviolet Spectrophtomtric method Aqueous acid at 262 nm
Limit conformity 95 – 105%
Reference : Clarke’s Analysis of Drugs and Poisons, 40TH
Uses of acriflavinium chloride
Acriflavine is a topical antiseptic.
0.1% used for the treatment of wounds or burns &
for skin infection
Acriflavine is also used as treatment for external
fungal infections of aquarium fish.
Acriflavine has been shown to have anti-cancer
activity.
Method Analysis of Glutaraldehyde
pH meter Method Limite conformity 90–110%
Referance : Indian Pharmacopeia
0.1M NaOH
Titration to pH:3.
Acidified Glutaraldehyde
by 10% hydroxyl amine.
Glutaraldehyde
Glutaraldehyde has gained wide acceptance as a
high-level disinfectant and chemical sterilant.
Glutaral is non-corrosive towards most materials.
Aqueous solutions of glutaraldehyde are acidic
and generally in this state are not sporicidal.
Only when the solution is "activated" (made
alkaline) by use of alkalinating agents to pH 7.5–
8.5 does the solution become sporicidal.
Glutaraldehyde
Optimum activity between pH 7.5 and 8.5; such
solutions are chemically stable for about 14 days.
Solutions at lower pH values are more stable.
Once activated, these solutions have a shelf-life of
minimally 14 days because of the polymerization
of the glutaraldehyde molecules at alkaline pH
levels.
(aldehyde groups) of the glutaraldehyde molecules
that are responsible for its biocidal activity.
Disinfection & Sterilization of
Glutaraldehyde
immersion 10 to 20 min.
rapidly effective against
• Gram-positive
• Gram-negative
• Mycobacterium tuberculosis
• Some fungi
• Some viruses
(hepatitis B & HIV)
.
.
Disinfection
immersion up to 10 hrs.
slowly effective against
• Bacterial spores
.
.
.
.
.
.
. Sterilization
Uses and Administration
A 2% aqueous solution buffered to a pH 8
(activated glutaral; alkaline glutaral) may be used
for the sterilisation of endoscopic and dental
instruments, rubber or plastic equipment, and for
other equipment which cannot be sterilised by
heat.
Clean
Instruments
Rinse
Instruments Dry
Activate
Solution Testing
Disinfection
&
Sterilization
Disposal
HOW TO USE ACTIVATED CIDEX SOLUTION
1. Clean Instruments
Instruments must be cleaned since residual organic
matter will decrease the effectiveness of the CIDEX®
Solutions.
Clean (e.g., endoscopes) with detergent Solution
which are mild in pH, low foaming, and easily rinsed.
Rinse instrument with large amounts of fresh water.
Remove excess moisture. This will help prevent
rapidly diluting the CIDEX® Solution.
2. Activate solution
Prepare Active CIDEX® Solution :-
Add the activator to the container.
Shake well. Activated solution immediately
changes color.
Do not use activated solution beyond stated
14- or 28-day reuse life.
Record date of activation (mixing date) &
expiration date.
3. Testing
Do not rely solely on days in use.
CIDEX® Solutions must be tested prior
to each use with the Test Strip.
It is recommended that CIDEX®
Solutions be tested before each usage.
4. Disinfection / Sterilization
Immerse clean, dry instruments completely in the
CIDEX® Solution.
Fill all lumens.
Cover the CIDEX® Solution tray or bucket with a
secure lid to reduce exposure to glutaraldehyde
vapors which can be irritating,
Result in irritation to the respiratory tract and eyes, stinging sensation
in the nose and throat or difficulty breathing.
5. Rinse Instruments
For devices that have been sterilized:
using sterile technique and rinse thoroughly with sterile water.
Following disinfection, aseptically:
rinse instruments thoroughly, flushing the channels with potable or
sterile water.
Be sure to repeat this procedure twice, for a total
of three rinses.
Each rinse should be a minimum of one minute in
duration, and a large volume of fresh water (e.g.,
two gallons) must be used for each rinse.
6. Dry
High-level disinfected or sterilized
Disinfected or sterilized stored in a manner to
minimize recontamination.
Dry
Assay of active ingredient of
antiseptic & disinfectant chemicals.
Sterility test of drugs, medical
supplies and surgical equipment's.
Antimicrobial activity of antiseptic &
disinfectant chemicals.
The role of the Public Health
Laboratory in infection control
Recommendations
Periodic mentoring on antiseptic & disinfectant products on
many status
Awareness lectures & instruction guidelines for stuff in the
sterilization & medical departments.
Practical training for technical stuff to good implantation for the
disinfectant and sterilization protocol.
Support facilities of drug analysis dep. to test types of antiseptic
& disinfectant products.