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Chapter 95Chapter 95

Antiseptics and DisinfectantsAntiseptics and Disinfectants

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TerminologyTerminology

AntisepticAntiseptic Applied to living tissueApplied to living tissue

DisinfectantDisinfectant Applied to objectsApplied to objects Too harsh for living tissueToo harsh for living tissue Applied most frequently to instruments and Applied most frequently to instruments and

facilitiesfacilities

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TerminologyTerminology

SterilizationSterilization Complete destruction of all microorganismsComplete destruction of all microorganisms

SanitizationSanitization Contamination has been reducedContamination has been reduced

GermicideGermicide Decreases growth and replication but does not kill Decreases growth and replication but does not kill

germsgerms

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Ideal AntisepticIdeal Antiseptic

SafeSafe EffectiveEffective SelectiveSelective GermicidalGermicidal Broad spectrum of antimicrobial activityBroad spectrum of antimicrobial activity

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Time Course of ActionTime Course of Action

Toxicity to organisms determined by duration Toxicity to organisms determined by duration of exposure to the antiseptic/disinfectantof exposure to the antiseptic/disinfectant Ethanol 70% reduces bacterial count by 50% in 36 Ethanol 70% reduces bacterial count by 50% in 36

seconds.seconds. Benzalkonium chloride requires 7 minutes for the Benzalkonium chloride requires 7 minutes for the

same effect.same effect.

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Antiseptics to Treat Established Antiseptics to Treat Established Local InfectionLocal Infection

Topical agents were used in the past.Topical agents were used in the past. Systemic anti-infective drugs are now the Systemic anti-infective drugs are now the

treatment of choice.treatment of choice. More effective than topicalMore effective than topical Don’t damage inflamed/abraded tissueDon’t damage inflamed/abraded tissue

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Most Effective Use of Antiseptics and Most Effective Use of Antiseptics and DisinfectantsDisinfectants

Antiseptics applied directly to the patient Antiseptics applied directly to the patient contribute relatively little prophylaxis against contribute relatively little prophylaxis against infection (except neutropenic).infection (except neutropenic). Study found most post-op infections are caused by Study found most post-op infections are caused by

organisms not present at incision site.organisms not present at incision site. Use of antiseptics by nurses, physicians, and Use of antiseptics by nurses, physicians, and

those who contact the patient offers much those who contact the patient offers much greater protection.greater protection.

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Common Antiseptics and Common Antiseptics and DisinfectantsDisinfectants

Alcohol Alcohol – – ethanolethanol Aldehydes Aldehydes – – glutaral (Cidex)glutaral (Cidex) Iodine compoundsIodine compounds Chlorine compounds Chlorine compounds – – oxychlorosene sodiumoxychlorosene sodium PhenolsPhenols HexachloropheneHexachlorophene

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Common Antiseptics and Common Antiseptics and DisinfectantsDisinfectants

ChlorhexidineChlorhexidine Hydrogen peroxideHydrogen peroxide ThimerosalThimerosal Benzalkonium chlorideBenzalkonium chloride

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Hand Hygiene for Healthcare Hand Hygiene for Healthcare WorkersWorkers

Effective hygiene Effective hygiene – – single most important single most important factor in preventing the spread of infection in factor in preventing the spread of infection in healthcare settingshealthcare settings

2 million hospital-acquired infections per year2 million hospital-acquired infections per year CDC recommends alcohol-based handrubs CDC recommends alcohol-based handrubs

for routine hand antisepsisfor routine hand antisepsis AccessibilityAccessibility Time savingsTime savings Lessened skin damageLessened skin damage Greater efficacyGreater efficacy

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Hand Hygiene for Healthcare Hand Hygiene for Healthcare WorkersWorkers

Specific CDC hand-hygiene Specific CDC hand-hygiene recommendationsrecommendations Categories IA, IB, IC, II, and no Categories IA, IB, IC, II, and no

recommendation/unresolved issuerecommendation/unresolved issue Indications for hand washing and antisepsisIndications for hand washing and antisepsis Hand-hygiene techniqueHand-hygiene technique Surgical hand antisepsisSurgical hand antisepsis Other aspects of hand hygieneOther aspects of hand hygiene Administrative measures regarding hand hygieneAdministrative measures regarding hand hygiene