Chlorhexidine

Surgical site infection (SSI) is one of the most frequent health care-associated infections. One of the practices to reduce their incidence is preoperative skin antisepsis. Two of the most commonly active components used are chlorhexidine gluconate and povidone iodine. Of 3 reviews conducted between 2010 and 2012 comparing antiseptics, 2 were in favor of chlorhexidine; however, the latest was unable to draw conclusions. To verify whether recent evidence supports the hypothesis that chlorhexidine in preoperative antisepsis is more efficient than other antiseptics in reducing SSI rates. We conducted a systematic review from 2000-2014 in all languages. The primary end point was SSI incidence and secondary skin bacterial colonization. Nineteen studies were included. Meta-analysis were conducted for comparable studies for both outcomes. The results of the meta-analysis, including all of the studies in which chlorhexidine was compared with iodophor, were in favor of chlorhexidine for both...

The effect of a commercially available triclosan-containing toothpaste compared to a sodium-fluoride-containing toothpaste and a chlorhexidine rinse on 4-day plaque regrowth Binney A, Addy M, McKeown S, Everatl L: The effect of a commerviaUy available triclosan-containing toothpaste compared to a sodium-fluoride-containing toothpaste and a chlorhexidine rinse on 4-day plaque regrowlh. J Clin Periodontol 1995; 22: 830-834. © Munksgaard, 1995. Abstract. Many compounds could be added to toothpaste to assist plaque inhibition, but ionic interactions can cause formulation difficulties. Moreover, the actual chemical action of a plaque inhibitory agent added to a toothpaste is difficult to assess when the product is used in the conventional manner, i.e., in addition to toothbrushing. The non-ionic antimicrobial triclosan has been incorporated in toothpastes and shown to have variable piaque inhibitory activity both alone and in conjunction with certain polymers or metal ions. Little is known of the efficacy of triclosan toothpastes compared to conventional fluoride toothpastes. The aim of this study was to compare a commercially available toothpaste containing 0.3% triclosan/co-polymer with a sodium fluoride toothpaste for chemical plaque inhibitory effects over a 4-day period. The study was designed to stratify the relative efficacy plaque inhibitory action of the products, comparisons were made with a positive control, chlorhexidine rinse and a negative control, saline. The study design was a randomised single blind crossover design balanced for first-order carryover. A total of 18 healthy, dentate volunteers participated in the study. On day i of each period the volunteers suspended toothcleaning and rinsed 2Xdai)y with the allocated mouthrinse or toothpaste slurry. On day 5, the plaque on the teeth was disclosed and scored by index and area. Increasing plaque scores were in the order chlorhexidine, triclosan toothpaste, fluoride toothpaste, and saline. Chlorhexidine was significantly more effective than all the other agents tested, and both toothpaste preparations were significantly better than the saline rinse. There was no significant difference between the two toothpaste rinses. Consistent with other studies the triclosan toothpaste offers only moderate plaque inhibitory properties when compared to a conventional toothpaste.

Background: Today several methods for decontaminating inner cannulae exist. These methods are not based on scientific data, but often on local clinical tradition. This study compares two different decontamination methods. The aim was to find a practical and safe decontamination method. It is a randomized, single-blinded, comparative crossover study. Methods: Fifty outpatients with long-term tracheostomy with an inner cannula were consecutively included and randomly allocated to begin with one of two different treatment sequences: detergent and chlorhexidine-alcohol (A) or detergent (B). Samples for bacterial culture were taken before and after decontamination, and the number of bacteria colonies was counted. Results: Before decontamination, the inner cannulae grew high numbers of bacteria, which were parts of the normal flora of the upper respiratory tract and did not differ significantly between the two sequences (AB; BA). The primary variable was the culture count value after chlorhexidine-alcohol/detergent (A) and detergent (B). The effects of both methods were larger than expected, and the results showed a nearly total elimination of organisms. The equivalence criterion, ratio of mean colony counts (A/B) .0.8, was met at a significance level of P , 0.001. Conclusions: Cleaning the tracheostomy inner cannula with detergent and water is sufficient to achieve decontamination.

The efficacy of antimicrobial central venous catheters (CVCs) remains questionable. In this network meta-analysis, we aimed to assess the comparative efficacy of antimicrobial CVC impregnations in reducing catheter-related infections in adults. We searched 4 electronic databases (Medline, the Cochrane Central Register of Controlled Trials, Embase, CINAHL) and internet sources for randomized controlled trials, ongoing clinical trials, and unpublished studies up to August 2016. Studies that assessed CVCs with antimicrobial impregnation with nonimpregnated catheters or catheters with another impregnation were included. Primary outcomes were clinically diagnosed sepsis, catheter-related bloodstream infection (CRBSI), and all-cause mortality. We performed a network meta-analysis to estimate risk ratio (RR) with 95% confidence interval (CI). Sixty studies with 17255 catheters were included. The effects of 14 impregnations were investigated. Both CRBSI and catheter colonization were the mo...

The aim of this work was the evaluation of conductivity assessments for the monitoring and controlling the release study process of chlorhexidine and lidocaine hydrochloride from the ionic polyacrylic gel, applying different temperatures. According to performed measurements of release, the chlorhexidine, characterized by very low water solubility, is observed in the acceptor compartment in the amount of 2.0-3.0% and its level depends of the temperature. The amount of well soluble lidocaine hydrochloride released in parallel conditions was between 60 and 70%. Beyond, the assessments confirm the presence of a specific bond between the chlorhexidine imine groups and polyacrylic acid carboxylic groups. Presented method may be applied in the prediction of release rates, before actual release analysis, and may assure better evaluation of the systems.

Chlorhexidine gluconate is a relatively commonly used chemotherapeutic in the treatment of periodontitis (P), exhibiting antimicrobial capabilities against Gram-negative and Gram-positive bacteria, and fungi. This compound is a component of various preparations for topical use in the form of solutions for mouthrinsing or peri-irrigation, gels, varnishes, chips and even chewing gums. The aim of the study was the clinical evaluation of periodontium after treatment with one of the drugs containing chlorhexidine gluconate (Corsodyl) as compared to professional tooth cleaning in patients with chronic periodontitis. MATERAL AND METHODS: Forty subjects enrolled in the study were divided into four groups, 10 in each group, according to the mode of treatment (Corsodyl rinse, Corsodyl gel, Corsodyl gel + surgical dressing, scaling). The greatest differences between baseline and follow-up examinations were observed in the group where surgical dressing was applied in addition to Corsodyl gel an...

Background: Cost-effectiveness analyses show that chlorhexidineesilver sulfadiazine (CHSS)impregnated catheters reduce catheter-related bloodstream infection (CRBSI) and central venous catheter (CVC)-related costs. However, no studies have reported the efficiency of CHSS-impregnated catheters for venous access when the risk of CRBSI is low; for example, at the subclavian site. This study determined the cost of a CVC, diagnosis of CRBSI, and antimicrobial agents to treat CRBSI; we did not consider the cost of increased hospital stay. Methods: This retrospective study included patients admitted to the intensive care unit at Hospital Universitario de Canarias (Tenerife, Spain) who had a subclavian venous catheter. Results: Patients with CHSS catheters (n ¼ 353) had a lower incidence density of CRBSI (2.12 vs 0 out of 1,000 catheter-days; P ¼ .02) and lower CVC-related cost per catheter-day (3.35 AE 3.75 vs 3.94 AE 9.95; P ¼ .002) than those with standard catheters (n ¼ 518). CHSS-impregnated catheters were associated with a lower risk of CRBSI (exact logistic regression) (odds ratio, 0.10; 95% confidence interval, ÀN to 0.667; P ¼ .008) than standard catheters when controlling for catheter duration. CHSS-impregnated catheters were also associated with a lower CVC-related cost per catheter day than standard catheters (Poisson regression) (odds ratio, 0.85; 95% confidence interval, 0.001-0.873; P < .001). Conclusions: CHSS-impregnated catheters may be efficient in preventing CRBSI in patients with subclavian venous access.

Recent research indicated that periopathogens colonize, besides the pockets, also other niches within the oral cavity including: the soft tissues, the saliva, the tongue, and even the tonsils. Since the supragingival plaque and the bacteria in these niches have a major impact on the ...

Methods: Eighty patients assigned to 4 groups had swabs of the upper eyelid skin taken before and after face wash with soap and water, and cleansing with Savlon and 5% povidone iodine. Specimens were cultured and Gram stained. Bacterial counts were carried out using standard techniques. Results: Face washing with soap and water increased the proportion of patients with bacterial isolates from 80.0% to 87.5%. The average colony count increased from 187.1 to 318.5 colony units per mL (p 5 0.02). Application of 5% povidone iodine without face washing with soap and water reduced the proportion of patients with bacterial isolates from 82.6% (mean count 196.5) to 28.6% (mean count 34.1) (p 5 0.001); in comparison, the application of 5% povidone iodine after face washing with soap and water reduced the proportion from 71.4% (mean count 133.9) to 40.0% (mean count 69.0) (p 5 0.01). Application of Savlon without face washing with soap and water reduced the proportion of patients with bacterial isolates from 100% (mean count 310.9) to 41.2% (mean count 19.8) (p 5 0.004) compared with the application after face washing, which reduced the proportion from 89.5% (mean count 240.3) to 41.2% (mean count 82.9) (p 5 0.02). Conclusions: Both povidone and Savlon are effective in reducing periocular bacteria in an African setting. Prior face washing with soap and water had no added benefit in reducing bacterial colony count. Objet : Établir l'effet du lavage de la figure à l'eau savonneuse et du nettoyage à l'iode de povidone et au gluconate de cétrimide/chlorhexidine (Savlon) sur les bactéries de la paupière supérieure. Nature : Étude clinique prospective, non randomisée. Participants : Quatre-vingt patients de la clinique oculaire de l'hô pital du Collège universitaire d'Ibadan (Nigéria). Mé thodes : Les 80 patients répartis en 4 groupes ont eu des prélèvements de la peau de la paupière supérieure avant et après le lavage facial à l'eau savonneuse, un nettoyage au Savlon et à l'iode de providone 5 %. Les spécimens ont fait l'objet de culture et de coloration de Gram. Les comptes bactériens ont été faits selon les techniques standard. Ré sultats : Le lavage de la figure à l'eau savonneuse a augmenté la proportion de patients qui avaient des isolats bactériens de 80,0 % à 87,5 %. En moyenne, le compte de la colonie a augmenté de 187,1 à 318,5 unités par mL (p 5 0,02). L'application d'iode de providone 5 % sans lavage de la figure à l'eau savonneuse a réduit la proportion des patients ayant des isolats bactériens, de 82,6 % (moyenne 196,5) à 28,6 % (moyenne 34,1) (p 5 0,001) ; comparativement, l'application d'iode de providone 5 % après le lavage de la figure à l'eau savonneuse a réduit la proportion de 71,4 %) (moyenne 133,9) à 40,0 % (moyenne 69,0) (p 5 0,01). L'application de Savlon sans lavage de la figure à l'eau savonneuse a réduit la proportion des patients avec isolats bactériens de 100 % (moyenne 310,9) à 41,2 % (moyenne 19,8) (p 5 0,004) comparativement à l'application après lavage de la figure, ce qui a réduit la proportion de 89,5 % (moyenne 240,3) à 41,2 % (moyenne 82,9) (p 5 0,02). Conclusions : Le providone et le Savlon sont tous deux efficaces pour réduire les bactéries périoculaires en milieu africain. Le lavage préalable de la figure à l'eau savonneuse n'a pas ajouté d'avantage pour la réduction du compte de la colonie bactérienne.

Several scientific works increasingly focus on the bacterial resistance caused by the prolonged use of antiseptics and antibiotics. Chlorhexidine is the most commonly used molecule in dentistry. There are many works that prove the effectiveness of Chlorhexidine, but its use is connected with collateral events. Massive use of Chlorhexidine would induce antibiotic resistance, for example for Klebsiella pneumoniae. Urticaria, severe rash, hissing breath, difficult breathing, cold sweats, light head feeling; swelling of the face, lips, tongue or throat are described during use of chlorhexidine. This medication can cause severe irritation or chemical burns in young children. Based on these considerations, the disadvantage risk of using these products should be carefully re-evaluated. The health of the oral cavity will be increasing re-evaluated and closely linked to human health.

Compare the efficacy of the cleaning technique usually employed in our healthcare facility to eliminate environmental contamination with cyclophosphamide with that of the Surface Safe commercial kit. This is a three-step evaluative and comparative study involving: (i) the voluntary contamination of the surface of a hood with a pre-established quantity of cyclophosphamide (20,000,000 ng), (ii) the cleaning of the work surface of the hood using a cleaning technique usually employed in our healthcare facility or that of the product Surface Safe, and (iii) the quantification of cyclophosphamide detected on the work surface. The usual cleaning technique involves the use of a mixture of 0.05% chlorhexidine and 70% ethyl alcohol to clean surfaces, whereas the product Surface Safe involves a combined two-step sodium hypochlorite and sodium thiosulfate wash. The median concentrations of cyclophosphamide detected after the use of the usual technique and the product Surface Safe came to 165 ng...

Pi 'i-iodoniol 1995'i-iodoniol : 22: 923-928. © Munksgaard. 1995 Ahsrraci. Staining ofleelh and mucous membranes is a well-known side-effect with chiorhexidine mouthrinses in which dietary chrotnogcns play an important role. The purpose of (his study was to detertnine whether a co-polymer antiadhcsivc agent would prevent staining by a low concentration chiorhexidine solution. Additionally, the possibility thai an essential oil/phenolic rinse product may cause staining was investigated. The rinses studied were the anti-adhesive alone and combined with 0.02'-'^. chiorhexidine and the essential oil/phenolie rinse. These were positioned against a positive control rinse, 0.2"/u chiorhexidine. and a negative control rinse, water. Tlie study was a single blind 5-trealment. randomised Latin square cross-over design, incorporating balance for carry-over effects. 15 volunteers participated and on Day 1 of each study period were rendered stain free by scaling and polishing of the teelh. Oral hygiene was suspended and 8x per day subjects rinsed under stipervision. firstly with the allocated formulation and then with 10 ml of warm black tea. On Day 4. tooth and tongue staining was scored by area and intensity (colour). A washout period of at least 3'/2 days was permitted between treatment periods when oral hygiene was resumed. Before ihe study and during washouts, volunteers practised tongue brushing. Tooth and tongue staining was significantly increased with 0.2% chiorhexidine compared to the essential oil/phenolic rinse which in turn was significantly increased compared to the other 3 rinses. The antiadhesive,'chlorhexidine rinse produced no more staining than the anti-adhesive or water rinse. However, the parallel plaque regrowth study suggests this inhibition of staining resulted from the vitiation of the chiorhexidine activity by the antiadhcsive. The methodology would appear a simple and quick way of assessing the propensity of mouthrinses to cause extrinsic staining.

An in vitro model system was employed to determine the relative binding affinities of a series of sixteen chlorhexidine analogs to acidic functional groups similar to those which are abundant in the oral cavity. The chlorhexidine analogs displayed a range of binding affinities and were displaced subsequent to binding from carboxylate and phosphonate substituted resins, although not from sulphonate substituted resins, by divalent cations or by saliva-like divalent cation-rich solutions. The agents were not displaced from such surfaces by monovalent cations. There appears to be no correlation between the relative binding affinities of agents to anionic groups and their previously observed in vitro antiplaque potencies.

SUMMARY Objective This in vitro study evaluated the influence of different cleansing techniques on the bond strength of self-adhesive cement to dentin. Methods and Materials A total of 33 noncarious human molars were sectioned mesiodistally and embedded in chemically cured resin with the buccal or lingual surfaces facing upward. Superficial dentin was exposed and resin disk provisional restorations were cemented to the dentin surfaces with noneugenol provisional cement and were stored in distilled water at 37°C. After seven days, the provisional restorations were removed and 13 specimens were randomly assigned to each of the five groups (n=13), according to the following cleansing treatments: G1—excavator (control); G2—0.12% chlorhexidine digluconate; G3—40% polyacrylic acid; G4—mixture of flour pumice and water; and G5—sandblasting with 50 μm aluminum oxide particles at a pressure of 87 psi. Resin composite disks (Filtek Supreme Plus, 3M ESPE Dental Products, St Paul, MN, USA) 4.7 ...

Aim: This study evaluated the bond strength of glass-fiber posts (GFP) to intrarradicular dentin in cervical, middle and apical thirds, after using ultrasonically activated irrigants. Methods: One hundred and twenty lower premolars sectioned and distributed into 10 groups (n=12), according to irrigant and ultrasonic treatments. The groups were 2.5% NaOCl (HS), 2% chlorhexidine digluconate (CL), 17% EDTA, saline (SF) distilled water (AD), plus or minus ultrasonic instrumentation, and posts were cemented whith RelyX ARC. Results: The bond strength was evaluated by means of the push-out test. Repeated measures three-way analysis of variance and Tukey test revealed that compared to EDTA 17%, CL and SF significantly reduced the bond strength of GFP, regardless of ultrasonic instrumentation and also independently from root third (p=0.015). The most prevalent failure type was adhesive between the dentin and cement for the EDTA and HS groups, followed by mixed failure for the CL and HS groups. GFP bond strength was not affected by ultrasonic instrumentation (p=0.114), nor was it different between root thirds (p=0.280). Conclusion: The GFP bond strength to root dentin was influenced by the irrigant used, being the greatest values obtained with 17% EDTA when compared to CL and SF with or without passive ultrasonic instrumentation.

Bisphosphonate induced necrosis of the jaws (BONJ) does not have a unique protocol of treatment and many therapeutic approaches have been arising in oral medicine with debatable results. A male and a female attended the University Oral Surgery Clinic presenting oral bone lesions induced by intravenous and oral bisphosphonates respectively as complications of dental extraction. Treatment included daily mouthwashes and weekly intra oral irrigations with 4 mg/L of aqueous-ozone, antibiotic therapy and sequential superficial debridment for sequestrectomies. Long-standing follow-ups showed complete mucosa covering of exposed bone area and resolution of purulent secretion. Antibacterial and antifungal properties of aqueous ozone may have played important roles in the treatment. The outcome measured intra oral examination and panoramic radiographs of the affected bone. The application of aqueous ozone daily mouthwashes and weekly professional irrigation were safe; free from adverse effects...

This study evaluates the effect of subgingival irrigation with a 1% chlorhexidine collagen gel in periodontal pockets as an adjunct procedure to scaling and root planing (SRP). Thirty-seven sites with probing depth (PD) of 5-7 mm and BANA positive in 6 patients with chronic periodontal disease were selected. Sites were assigned to different treatment groups consisting of SRP only (group 1), SRP + irrigation with collagen gel (group 2), or SRP + irrigation with collagen gel containing 1% chlorhexidine (group 3). Subgingival irrigation was performed after initial SRP and at 7, 14 and 21 days. Clinical measurements including PD, plaque index (PI), gingival index (GI), gingival recession (GI), bleeding on probing (BOP) and clinical attachment level (CAL) were performed at the selected sites at baseline, 60 and 90 days and the BANA test was performed on plaque samples from the same sites at baseline and 90 days. There was an improvement in clinical parameters in all groups with a signifi...

O tratamento ortodôntico envolve procedimentos, geralmente, realizados durante um longo período. No ato da remoção do aparelho, freqüentemente, são encontradas áreas de desmineralização sob braquetes e bandas, quando já não há cavitações e, na maioria das vezes, inflamações dos tecidos periodontais. Para evitar estas iatrogenias, o clínico geral ou o especialista e toda sua equipe devem estar realmente motivados e envolvidos na aplicação dos conceitos de Odontologia Preventiva em seus pacientes ou, pelo menos, dispostos a delegar esta tarefa a alguém capacitado para fazê-la. Existem métodos relativamente simples para se avaliar o potencial de colaboração do paciente com o tratamento proposto, antes mesmo de seu início, e de se manter este paciente em níveis aceitáveis de saúde bucal. A utilização de recursos áudiovisuais para motivar os pacientes, os reforços positivos, a realização de escovação supervisionada e da limpeza interdentária, orientação sobre higiene, manutenção de saúde bucal e dieta, utilização de diferentes tipos de acessórios ortodônticos e de agentes cimentantes, além do uso, quando necessário, de diversos métodos químicos, são importantes instrumentos a serem utilizados durante o tratamento ortodôntico. Tomando-se as devidas precauções, é possível alcançar uma oclusão funcional e esteticamente aceitável sem deixar que a doença tenha um papel coadjuvante no transcorrer e após o término do tratamento ortodôntico.

Since chlorhexidine is effective against microorganisms, it is widely recommended in dentistry. However, studies have provided evidence that chlorhexidine is toxic for a variety of cell types. In order to identify potential genotoxins in different cell types, the purpose of this study was to investigate whether chlorhexidine digluconate is able to cause, in terms of DNA damage, alterations in leukocytes, liver, kidney and urinary bladder by the single cell gel (comet) assay. Ten male Wistar rats were divided into two groups: a negative control and the experimental group treated with 3 ml of 0.12% chlorhexidine digluconate by gavage once a day for 8 days. Statistically significant increases of DNA damage was observed in leukocytes and kidney cells of the chlorhexidine digluconate treated group as depicted by the mean tail moment. Taken together, the data indicate that leukocytes and kidney cells are potential targets for primary DNA damage following oral exposure to chlorhexidine digluconate as detected by single cell gel (comet) assay.

Needleless connectors, including the standard split septum and the luer-activated mechanical valve connectors, have been introduced into clinical practice to eliminate the risk of needlestick injuries by avoiding the use of needles when accessing the intravascular catheters. Negative and positive displacement mechanical valves have been associated with increased rates of catheter-related bloodstream infections as compared with split septum connectors. Based on available data, split septum connectors should be preferentially used instead of mechanical valves. Adequate disinfection by scrubbing the access port preferably with chlorhexidine is recommended to minimize the risk of catheter microbial contamination along with proper infection control practices. Large prospective randomized clinical trials are needed to evaluate further the possible causes and effects of different types of mechanical valve needleless connectors on bloodstream infections.

We eondueted a prospeetive, randomized, double-blind, plaeebo-eontrolled, multieenterstudy to assess the effieaey ofehlorhexidineglueonate/benzydamine HCl mouth spray for redueingpain and improving quality of life in patients with aeute viral pharyngitis. Prior to treatment, patients rated the intensity of their pain on a visual analog seale and evaluated their quality of life on the 36-Item Short-Form Health Survey. Patients were then randomized to reeeive either paraeetamol (aeetaminophen) plus ehlorhexidine/ benzydamine or paracetamol plus plaeebo for 7 days. On days 3 and 7 of treatment, the partieipants again rated the intensity of their pain, and on day 7, they again rated their quality of life. A total ofl 64 patients were évaluable at study's end-80 in the ehlorhexidine/benzydamine group and 84 in the eontrol group. A eomparison of self-evaluations revealed that the aetive treatment group reported less pain on both day 3 (p < 0.001) and day 7 (p = 0.002). Likewise, the ehlorhexidine/benzydamine group reported a signifieantly better quality of life on day 7 (p < 0.001). ehlorhexidine/benzydamine was well tolerated, and no serious adverse events were observed.

Carica papaya is traditionally used to treat various skin disorders, including wounds. It is widely used in developing countries as an effective and readily available treatment of various wounds, particularly burns. This study was aimed at investigating the healing efficiency of papaya latex formulated as 1.0 and 2.5% hydrogels. Burns were induced in Swiss albino mice divided into five groups as following; Group-I (negative control) received no treatment. Group-II was treated with Carbopol 974P NF empty gel. Groups-III and -IV were treated with Carbopol gel containing 1.0 and 2.5% of dried papaya latex, respectively. Group-V (positive control) received the standard drug (silver sulphadiazine and chlorhexidine gluconate cream). The efficacy of treatment was evaluated based on the hydroxyproline content, wound contraction and epithelialization time. Hydroxyproline content was found to be significantly increased in the Group-III. Significant increase in percentage wound contraction was observed from day 12 in Group-IV and from day 20 in Groups-III and -V. The epithelialization time was found to be the shortest in Group-IV. It may be concluded that papaya latex formulated in the Carbopol gel is effective in the treatment of burns and thus supports its traditional use.

Background: There is a lack of research studies on periurethral cleansing before catheterization among home care patients. The purpose of this study was to compare the risk of acquiring symptomatic urinary tract infections through the conventional practice of using 0.05% chlorhexidine gluconate (CHG) versus sterile water for periurethral cleansing before insertion of an indwelling urinary catheter. Methods: A randomized controlled trial was used, and subjects were randomly allocated to either the sterile water group or the 0.05% CHG group. Urine specimens for culture were collected 4 times for each subject within 2 weeks. Results: Seventy-four urine samples were collected in 20 subjects (sterile water group, 8; 0.05% CHG group, 12). There was no significant difference in colonization count between the 2 groups. In addition, none of the subjects in the 2 groups developed symptomatic bacteriuria. Conclusion: Using sterile water to clean the periurethral area before catheterization among home care patients will not increase the risk for urinary tract infections.

Surgical hand disinfection (with an alcohol-based hand rub) and surgical handwash (with an antiseptic-based liquid soap) are accepted measures to reduce the risk for surgical site infections. The new European Standards allow a comparison of their antimicrobial efficacy. The bactericidal activity of surgical hand rubs [Sterillium and Softaman, (active ingredient ¼ alcohols)] and handwashes [Derman plus (triclosan), Hibiscrub (chlorhexidine) and Betadine (PVP -iodine)] was tested according to the prEN 12054 suspension test using Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus hirae, and to prEN 12791 for the effect on resident skin flora in comparison with 1-propanol, 60% (v/v). All five products achieved a reduction of test bacteria within 3 min of . 10 5 -fold so fulfilling prEN 12054. However, only Hibiscrub, Sterillium and Softa Man met the requirements of prEN 12791, giving a mean reduction of resident micro-organisms (immediate and sustained effect) which was not significantly lower than the reference alcohol (P . 0.1; Wilcoxon matched-pairs signed-rank test). Sterillium was significantly more effective than the reference alcohol (immediate and sustained affect). Products for surgical hand disinfection may have equal antimicrobial activity in suspension tests but show large differences under practical conditions. Healthcare workers should not rely on results from suspension tests when deciding on a product for surgical hand disinfection.

The aim of this study was to assess in vitro the antimicrobial activity of 2% chlorhexidine gel against Enterococcus faecalis, comparing it to other endodontic irrigants (2% chlorhexidine liquid and 5.25% sodium hypochlorite). Study design. Eighty roots of human mandibular premolars were prepared by serial instrumentation technique, autoclaved, and contaminated for 7 days with E faecalis monocultures. The roots were then divided into 5 groups according to the irrigant substance used during the standardized biomechanical preparation. In order to evaluate the antimicrobial action of the irrigant substances, 3 microbial samples were taken: initial (before the biomechanical preparation); post-treatment (immediately after the biomechanical preparation), and final (7 days after the biomechanical preparation). The microbiological samples were plated to count the colony-forming units (CFU). Results. The 2% chlorhexidine gel and 2% chlorhexidine liquid significantly reduced the E faecalis CFU in the post-treatment and final microbiological samples. The 5.25% sodium hypochlorite also reduced the E faecalis CFU immediately after the root canal instrumentation, but it was not able to keep the root canal free of detectable E faecalis in the final sample. Conclusions. The 2% chlorhexidine gluconate (gel and liquid) antimicrobial ability was more effective than 5.25% sodium hypochlorite in keeping low CFU of E faecalis for 7 days after the biomechanical preparation.

Free-living amoebae of the genus Acanthamoeba are causal agents of a severe sight-threatening infection of the cornea known as Acanthamoeba keratitis. Moreover, the number of reported cases worldwide is increasing year after year, mostly in contact lens wearers, although cases have also been reported in non-contact lens wearers. Interestingly, Acanthamoeba keratitis has remained significant, despite our advances in antimicrobial chemotherapy and supportive care. In part, this is due to an incomplete understanding of the pathogenesis and pathophysiology of the disease, diagnostic delays and problems associated with chemotherapeutic interventions. In view of the devastating nature of this disease, here we present our current understanding of Acanthamoeba keratitis and molecular mechanisms associated with the disease, as well as virulence traits of Acanthamoeba that may be potential targets for improved diagnosis, therapeutic interventions and/or for the development of preventative measures. Novel molecular approaches such as proteomics, RNAi and a consensus in the diagnostic approaches for a suspected case of Acanthamoeba keratitis are proposed and reviewed based on data which have been compiled after years of working on this amoebic organism using many different techniques and listening to many experts in this field at conferences, workshops and international meetings. Altogether, this review may serve as the milestone for developing an effective solution for the prevention, control and treatment of Acanthamoeba infections.

Although the plasma technology has long been applied to treat contact lenses, the effect of this treatment on the performance of drug-loaded contact lenses is still unclear. The objective of this work is to study the effect of nitrogen plasma treatment on two drug-loaded polymeric formulations which previously demonstrated to be suitable for therapeutic contact lenses: a poly-hydroxyethylmethacrylate (pHEMA) based hydrogel loaded with levofloxacin and a silicone-based hydrogel loaded with chlorhexidine. Modifications of the surface and the optical properties, and alterations in the drug release profiles and possible losses of the antimicrobial activities of the drugs induced by the plasma treatment were assessed. The results showed that, depending on the system and on the processing conditions, the plasma treatment may be beneficial for increasing wettability and refractive index, without degrading the lens surface. From the point of view of drug delivery, plasma irradiation at moderate power (200 W) decreased the initial release rate and the amount of released drug, maintaining the drug activity. For lower (100 W) and higher powers (300 W), almost no effect was detected because the treatment was, respectively, too soft and too aggressive for the lens materials. V C 2014 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 00B: 000-000, 2014.

The article describes the pharmacocodynamics of povidone-iodine, the release form under the brand name Betadine, pharmacological benefits, as well as evidence of its effectiveness in preventing infection in the field of surgical intervention. Povidone-iodine is indicated to be a depot of iodine, constantly releasing elemental iodine, which has strong oxidizing properties, and therefore most microorganisms are destroyed in vitro in less than a minute, and the main destructive effect of the drug occurs in the first 15–30 seconds. Povidone-iodine has a wide spectrum of antimicrobial and antiviral action.

The data on medications of povidone-iodine in the form of vaginal suppositories, antiseptic solution and ointment under the trade name Betadine are presented. Own data on the effective use of vaginal suppositories in symptomatic vaginal dysbiosis caused by mixed opportunistic bacterial flora (facultative and obligate anaerobes) with the presence of Atopobium vaginae in diagnostically significant amounts are presented.

In the presented comparative studies, the advantages of Betadine compared with other antiseptics in the spectrum of microbiological effects, resistance of microorganisms, effects on wound healing, dependence of the effect on the physico-chemical parameters of the environment, side effects, the purpose of application – prevention and/or treatment are shown.

The results of recent comparative studies on the treatment of the surgical area with chlohexidine-alcohol and povidone-iodine, according to which povidone-iodine should still be considered acceptable for the preoperative treatment of the caesarean section, are highlighted. It is indicated that the irrigation of the wound cavity with an aqueous solution of povidone-iodine during surgery and before suturing the surgical wound is one of the WHO recommendations for the prevention of infection in the field of surgical intervention.

The authors conclude that povidone-iodine, including Betadine, has a broad spectrum of antimicrobial and antiviral activity; high activity in the presence of organic compounds (blood, pus); ability to penetrate through biofilms, necrotic tissue, eschar; low incidence of antiseptic resistance; positive dynamics of wound healing by preventing the spread of inflammation and increasing the ability to heal; well tolerated by patients; low cost; ease of use.

This issue of Special Care in Dentistry presents protocols that were designed during a conference, Practical Protocols for the Prevention of Dental Disease in Community Settings for People with Special Needs, which was held at the University of the Pacific School of Dentistry on February 1, 2002. After each expert reviewed and reported on one area of the literature, which included risk assessment; chlorhexidine mouth rinses; xylitol chewing gum; topical fluoride and fluoride varnish applications; and methods to control or treat periodontal disease, practical protocols were developed. Next, a strategy of implementation and dissemination will be designed using nurses, case managers, social workers, caregivers, and others to encourage people with special needs to use these protocols. A plan will also be implemented to increase social and health care provider awareness about these interventions through professional publications and educational opportunities. The goal is to reduce dental disease in special needs populations and thereby decrease the need for difficult and costly treatment.