MIC tests are not suitable for assessing antiseptic handwashes.
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Biomedical subjects
Publications and source records attributed to R A Bucknall.
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Suspensions of Escherichia coli and Klebsiella aerogenes were exposed to low levels of chlorhexidine, which had little effect on their in vitro viability. A substantial reduction in their in vivo infectivity measured by intraperitoneal inoculation of mice was found. This selective reduction in bacterial infectivity by chlorhexidine should be taken into account when conventional in vitro tests are used to assess the clinical effectiveness of chlorhexidine-containing antiseptics.
Two of the products commonly used to disinfect the hands of nursing staff are 70% isopropanol and aqueous chlorhexidine-detergent solutions. These have been shown to rapidly destroy respiratory syncytial virus, and are therefore suitable for use where contagious spread of this virus is suspected. The virucidal component of the chlorhexidine-detergent preparation has been shown to be primarily the detergent base and not the chlorhexidine.
A model of bacterial peritonitis, using mice infected with Escherichia coli, has been used to assess the protective effects of intraperitoneal treatment with antiseptics. Of the five antiseptics tested, only chlorhexidine gluconate had any protective effect, concentrations of 0.05 and 0.02 per cent reducing the mortality to 14 and 50 per cent respectively. The other antiseptics, taurolin, noxytiolin, povidone iodine and hypochlorite were all ineffective. Delayed treatment with chlorhexidine was not as effective as instillation immediately postinfection.
An experimental wound infection model was used to assess the value of four proprietary antiseptics applied topically in preventing the development of wound sepsis. Irrigation of wounds with either saline or noxytiolin 15 min after contamination with Staphylococcus aureus did not reduce either the incidence or degree of infection. Benzalkonium chloride and, to a lesser degree, povidone-iodine significantly reduced the infection rate, but were inferior to chlorhexidine gluconate which eliminated all overt signs of infection. The rate of healing of the chlorhexidine-treated, contaminated wounds was found to be no different from control non-infected wounds. When irrigation was carried out 45 min before wounds were contaminated, chlorhexidine was the only treatment which reduced the rate of infection (P less than 0.001). It is concluded that the superior activity of chlorhexidine in this model is a good indication that it should be a highly effective agent in the prevention of staphylococcal wound infection, and that this is probably due to a combination of bactericidal and persistent action together with low toxicity.
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Aphidicolin is an antibiotic of novel structure produced by the mold Cephalosporium aphidicola. It is a potent inhibitor of cellular deoxyribonucleic acid synthesis, and it also strongly inhibits the growth of herpes simplex virus both in tissue culture and in the rabbit eye. Aphidicolin is active against iododeoxyuridine-resistant herpes virus, and does not itself readily induce the formation of drug-resistant strains of herpesvirus.
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