Download AntibioticsAntisepti..

Community-acquired infections

Acquired in the home or any place in the
community other than a health care facility
Nosocomial infections

Contracted in a hospital or institutional setting

Were not present or incubating in the patient on
admission to the facility

More difficult to treat because the causative
microorganisms are often drug resistant and the
most virulent
Agents used to reduce the risk of nosocomial infections
 Antiseptics


Inhibit growth of microorganisms but do not necessarily kill
them
Used on living tissue
 Disinfectants


Kill organisms
Used on nonliving surfaces
 Living
tissue cannot be sterilized
 Antiseptics
are applied to living tissue
( skin and mucous membranes),

to reduce the risk of infection by reducing the number of
microorganisms that can enter the body via an incision or
injection site
 Antiseptics



may be used for:
Presurgical hand scrubs for members of the
surgical team
Preoperative skin preparation
Irrigation of body cavities
 Forms

Surgical soaps, ointments, mouthwashes, topical
solutions, douches
Disinfectants
Used to remove microorganisms from inanimate
objects such as tabletops and surgical equipment
 Acetic

acid (vinegar)
1% or 5% solution
 Benzoic,
boric, or lactic acids
 Antibacterial,
 Otic
antifungal, bladder irrigation
solution or irrigation solution in various
strengths
Isopropyl alcohol or ethanol
 Most
effective at 60% to 70% concentrations
 “Cidal”
activity decreases at more than 95% or less
than 60%
 Used
as a skin astringent, cleansing agent, and to
disinfect utensils
formaldehyde and glutaraldehyde (Cidex)
 Caustic,
and may cause burns to skin and mucous
membranes
 Used
mostly as disinfectants
 Cidex
is used to sterilize surgical equipment
chlorhexidine gluconate (Hibiclens)
 Used
as a bactericidal skin-cleansing solution
(surgical scrub, handwashing agent, and a skin
wound cleanser)
Gentian violet, others
 Gentian
violet is used as a 1% or 2% solution
 Topical antiinfective
 Antibacterial and antifungal activity
 Dilute




sodium hypochlorite (Dakin’s solution)
Antibacterial antiseptic irrigation
5% solution used to disinfect utensils, floors, furniture
0.5% solution used topically on the skin
Household bleach solutions are 5.25%
 halazone:


chloramine compound
Available in tablet form
Used to sanitize drinking water

1 or 2 tablets in a liter of water can kill water-borne
pathogens within 30 to 60 minutes
 thimerosal




(Merthiolate)
Organic mercurial agent
Topical antiseptic, primarily antibacterial
Bacteriostatic
Less irritating and less toxic than inorganic mercurials
 Ammoniated


mercury
Inorganic mercurial agent
Used to treat impetigo, psoriasis, pediculosis,
other skin conditions
 Iodine
 Kill
all forms of microorganisms
 Used


tincture and solution
as a topical antiseptic
povidone-iodine (Betadine)
Comes in various forms

Aerosol, topical solution, mouthwash, surgical scrub
 hydrogen
peroxide

Bactericidal and virucidal; higher concentrations are
sporicidal

Use as wound irrigation solution is controversial

may be detrimental to wound healing in that it can destroy
newly forming cells as well as bacteria
 benzoyl
peroxide
 potassium
permanganate

cresol, carbolic acid (phenol), Lysol


chloraseptic


used as an oral antiseptic
hexachlorophene


Used as disinfectants; can burn and blister skin
Bacteriostatic skin cleanser and surgical scrub
resorcinol

Used for a variety of skin conditions
 benzalkonium
chloride (Zephiran)
 Bacteriostatic
at low concentrations
 Bactericidal
 Used
and fungicidal at high concentrations
as a skin cleanser, antiseptic irrigation
solution, and for instrument storage

Assess for drug and other allergies, or previous
sensitivities to antiseptics or other topical agents

If an iodine-based agent is to be used,
assess for allergies to iodine or seafood


these allergies are contraindications
Before using antiseptics, assess:





The concentration of the medication
Length of exposure to the skin
Condition of the skin
Size of area affected
Hydration status of the skin

Before applying a topical agent, ensure correct
technique and adequate supplies needed for the
procedure

Assess the area to be treated beforehand

Follow specific directions for cleansing the area

Follow manufacturer’s specific guidelines for application

Protect the site as ordered with a dressing if needed

Teach the patient proper technique for application of
the medication and dressings as needed
When using these agents on inanimate objects,
be sure to protect the patient (and yourself!)
from accidental exposure
 Monitor



for therapeutic response
Improved healing of the affected area
Decreased symptoms of inflammation or infection
Prevention of infection
 Monitor
for adverse effects or reactions