Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc. Chapter 95 Antiseptics and Disinfectants

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.2 Terminology  Antiseptic  Applied to living tissue  Disinfectant  Applied to objects  Too harsh for living tissue  Applied most frequently to instruments and facilities

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.3 Terminology  Sterilization  Complete destruction of all microorganisms  Sanitization  Contamination has been reduced  Germicide  Decreases growth and replication but does not kill germs

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.4 Ideal Antiseptic  Safe  Effective  Selective  Germicidal  Broad spectrum of antimicrobial activity

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.5 Time Course of Action  Toxicity to organisms determined by duration of exposure to the antiseptic/disinfectant  Ethanol 70% reduces bacterial count by 50% in 36 seconds.  Benzalkonium chloride requires 7 minutes for the same effect.

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.6 Antiseptics to Treat Established Local Infection  Topical agents were used in the past.  Systemic anti-infective drugs are now the treatment of choice.  More effective than topical  Don’t damage inflamed/abraded tissue

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.7 Most Effective Use of Antiseptics and Disinfectants  Antiseptics applied directly to the patient contribute relatively little prophylaxis against infection (except neutropenic).  Study found most post-op infections are caused by organisms not present at incision site.  Use of antiseptics by nurses, physicians, and those who contact the patient offers much greater protection.

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.8 Common Antiseptics and Disinfectants  Alcohol – ethanol  Aldehydes – glutaral (Cidex)  Iodine compounds  Chlorine compounds – oxychlorosene sodium  Phenols  Hexachlorophene

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.9 Common Antiseptics and Disinfectants  Chlorhexidine  Hydrogen peroxide  Thimerosal  Benzalkonium chloride

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.10 Hand Hygiene for Healthcare Workers  Effective hygiene – single most important factor in preventing the spread of infection in healthcare settings  2 million hospital-acquired infections per year  CDC recommends alcohol-based handrubs for routine hand antisepsis  Accessibility  Time savings  Lessened skin damage  Greater efficacy

Elsevier Inc. items and derived items © 2010 by Saunders, an imprint of Elsevier Inc.11 Hand Hygiene for Healthcare Workers  Specific CDC hand-hygiene recommendations  Categories IA, IB, IC, II, and no recommendation/unresolved issue  Indications for hand washing and antisepsis  Hand-hygiene technique  Surgical hand antisepsis  Other aspects of hand hygiene  Administrative measures regarding hand hygiene