Antiseptics, disinfectants, and sterilants are a diverse group of antimicrobials used to prevent infection (Table 102–1). Although these terms are sometimes used interchangeably and some of these xenobiotics are used for both antisepsis and disinfection, the distinguishing characteristics between the groups are important to emphasize. An antiseptic is a chemical that is applied to living tissue to kill or inhibit microorganisms. Iodophors, chlorhexidine, and the alcohols (ethanol and isopropanol) are commonly used antiseptics. A disinfectant is a chemical or physical agent that is applied to inanimate objects to kill microorganisms. Bleach (sodium hypochlorite), phenolic compounds, and formaldehyde are examples of currently used disinfectants. Neither antiseptics nor disinfectants have complete sporicidal activity. A sterilant is a chemical or physical process that is applied to inanimate objects to kill all microorganisms as well as spores. Ethylene oxide and glutaraldehyde are examples of sterilants. Not unexpectedly many of the xenobiotics used to kill microorganisms also demonstrate considerable human toxicity.17,60
Table 102–1. Antiseptics, Disinfectants, Sterilants, and Related Xenobiotics |Favorite Table|Download (.pdf)
Table 102–1. Antiseptics, Disinfectants, Sterilants, and Related Xenobiotics
|Xenobiotic||Commercial Product||Use||Toxic Effects||Therapeutics and Evaluation|
|Boric acid||Borax||Antiseptic||Blue-green emesis and diarrhea||GI decontamination|
|Sodium perborate||Mouthwash||Boiled lobster appearance of skin||Hemodialysis (rare)|
|Dobell solution||Eyewash||CNS depression; renal failure|
|(Chaps. 77 and 107)|
|Ethanol||Rubbing alcohol||Antiseptic||CNS depression||Supportive|
|(70% ethanol)||Disinfectant||Respiratory depression|
|Isopropanol||Rubbing alcohol||Antiseptic||CNS depression||Supportive|
|(70% isopropanol)||Disinfectant||Respiratory depression||Hemodialysis (rare)|
|(37% formaldehyde, 12%–15% methanol)||Fixative||CNS depression||Hemodialysis|
|Urea insulation||Carcinogen||Sodium bicarbonate|
|Glutaraldehyde||Cidex (2% glutaraldehyde)||Sterilant||Mucosal and dermal irritant||Supportive|
|Chlorates||Sodium chlorate||Antiseptic||Hemolytic anemia||Exchange transfusion|
|Chlorophors (sodium hypochlorite)||Household bleach (5% NaOCl)||Disinfectant||Mild Gl irritation||Endoscopy (rare)|
|Dakin solution (1 part 5% NaOCl, 10 parts H2O)||Decontaminating solution|
|Mercurials||Merbromin 2% (Mercurochrome)||Antiseptic (obsolete)||CNS||Gastric lavage, activated charcoal dimercaprol, succimer|
|(Chaps. 55 and 96)||Thimerosal (Merthiolate)||Renal|
|Iodine||Tincture of iodine (2% iodine, 2% sodium iodide and 50% ethanol)||Antiseptic||Caustic||Milk, starch, sodium thiosulfate|
|Lugol solution (5% iodine)|
|Iodophors||Povidone-iodine (Betadine) (0.01% iodine)||Antiseptic||Limited||Same as iodine|
|Hydrogen peroxide||H2O2 3%—household||Disinfectant||Oxygen emboli||Gastric lavage|
|H2O2 30%—industrial||Gl caustic||Radiographic evaluation|
|Potassium permanganate||Crystals, solution||Antiseptic||Oxidizer, caustic, increased serum manganese||Decontamination|
|Endoscopy as needed|
|Nonsubstituted||Phenol (carbolic acid)||Disinfectant||Caustic||Decontamination: polyethylene glycol or water|
|Cutaneous absorption||Endoscopy as needed|
|Quaternary Ammonium Compounds|
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