INTRODUCTION
Antiseptics are chemical agents of
disinfection that are mild enough to be used on human skin or tissues. They are
crucial in the prevention of wound infections, colonization of medical devices
as well as nosocomial and community transmission of microorganisms (Cairncross,
2000).
Because of these crucial roles, they
are expected to be of optimal efficacy an absence of which normally results in
substantial infectious morbidity, mortality and increased health care cost
(Boyce, 2002).
For antiseptics to function optimally
however, several factors have to be taken into consideration. One major factor
is the concentration of the antiseptic. It is known that there is an
exponential relationship between potency and concentration of an antimicrobial
agent (Gorman, 2004). This means that the more concentrated an agent, the
greater its efficacy, and the shorter the time necessary to destroy the
microorganisms. Because of the possibility of toxicity, however, the
concentration of antiseptics must be strictly controlled. Concentration
exponent is the numerical value that relates concentration to the antimicrobial
effectiveness of an antimicrobial agent. There are various classes of
antiseptics and agents which constitute members of these classes have similar
concentration exponents. Thus, peroxides have values of 0.5 to 1.0, aldehydes,
1.0, quaternary ammonium compounds, 0.8 to 2.5, phenolic compounds, 4 to 10.0
and aliphatic alcohols, 6.0 to 12.7. Other classes include: acids and their
esters, alcohols, biguanides, halogens, heavy metals, surface active agents,
quinoline and
isoquinoline derivatives and dyes
(Gorman, 2004). Antiseptics that are examples of each of these classes normally
constitute the active ingredients, either singly or in multiple, in the
antiseptics available under various trade names all over the world. The study
will in this regard examine the production of antiseptic.
Antiseptics and disinfectants are used
extensively in hospitals and other health care settings for a variety of
topical and hard-surface applications. in particular, they are an essential
part of infection control practices and aid in the prevention of nosocomial
infections (Gorman, 2004). Mounting concerns over the potential for microbial
contamination and infection risks in the food and general consumer markets have
also led to increased use of antiseptics and disinfectants by the general
public. A wide variety of active chemical agents (or "biocides") are
found in these products, many of which have been used for hundreds of years for
antisepsis, disinfection, and preservation (Eze, Ezeugwu, and Adikwu, 2019). Despite this, less is
known about the mode of action of these active agents than about antibiotics.
In general, biocides have a broader spectrum of activity than antibiotics, and,
while antibiotics tend to have specific intracellular targets, biocides may
have multiple targets. The widespread use of antiseptic and disinfectant
products has prompted some speculation on the development of microbial
resistance, in particular cross- resistance to antibiotics. This review
considers what is known about the mode of action of, and mechanisms of
microbial resistance to, antiseptics and disinfectants and attempts, wherever
possible, to relate current knowledge to the clinical environment.
A summary of the various types of
biocides used in antiseptics and disinfectants, their chemical structures, and
their clinical uses is shown in Table 1. It is important to note that many of
these biocides may be used singly or in combination in a variety of products
which vary considerably in activity against microorganisms. Antimicrobial
activity can be influenced by many factors such as formulation effects,
presence of an organic load, synergy, temperature, dilution, and test method.
These issues are beyond the scope of this review and are discussed elsewhere
(l23, 425, 444, 446, 451).
Whatever the type of microbial cell (or
entity), it is probable that there is a common sequence of events. This can be
envisaged as interaction of the antiseptic or disinfectant with the cell
surface followed by penetration into the cell and action at the target site(s).
The nature and composition of the surface vary from one cell type (or entity)
to another but can also alter as a result of changes in the environment (Food
and Drug Administration (FDA) United State of America 2016). Interaction at the
cell surface can produce a significant effect on viability (e.g. with
glutaraldehyde) (Kaliyadan, , Aboulmagd, . and Amin, 2014), but most antimicrobial agents appear
to be active intracellularly (Mwambete,
and Lyombe, 2011 Mwambete, and Lyombe,
2011).
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