Topical Antimicrobials: Classification and Performance

Since the discovery by Semmelweis that washing hands with chlorine decreased morbidity and mortality rates, the antimicrobial products market has grown tremendously. This chapter provides a brief introduction to the topical antimicrobial products currently on the market, how they are classified, how they work, and the purposes for which they are best suited. Among the first products used as a surgical scrub was an iodine complex (a tincture of iodine and an aqueous iodophor), which provides excellent immediate antimicrobial action. Another product, Chlorhexidine gluconate, which was first synthesized in 1950, has proved to provide high levels of antimicrobial activity and considerable effectiveness in healthcare personnel handwash applications. Alcohol and alcohol compounds also provide effective immediate effects but little to no residual or persistent activity. As the market has developed and scientific knowledge increased, product manufacturers have greatly improved product formulations, including the development of products containing quaternary ammonium compounds, which are used in household cleaners, disinfections, skin and hair care formulations, sanitizers, sterilizing solutions for medical devices, and even preservatives; parachlorometaxylenol product formulations are used primarily for healthcare personnel handwashes, as they are effective in removing transient microorganisms from the hands and have low skin irritation potential; and triclosan, which has fair immediate and persistent antimicrobial ability, but no residual action, has been formulated for a wide range of applications, including the food industry and consumer product lines. New products are constantly being formulated, tested, and brought to the market, according to the guidelines of the Food and Drug Administration.

Keywords: Alcohol, CHG, healthcare personnel handwash, iodine, PCMX, products, surgical scrubs, topical antimicrobial.