What is an antiseptic used for? This is one of those topics that require a special, careful approach. The fact is that there are many types of antiseptics. All of them should be used as directed, in a strictly defined dosage. The article presents the main types of antiseptics and their areas of application. Let's start with the definition.

What is an antiseptic?

Destroys putrefactive bacteria and prevents decomposition. The origin of the word is Greek. In translation "άντί" means "vs", a "σηπτικός" translates as "putrefactive" or "Festering".

Some antiseptics are germicidal and capable of destroying microbes, others are bacteriostatic and can only prevent or suppress their growth.

An antiseptic is a drug that has already been proven to be effective. Microbicides that have the ability to destroy viral particles are called "antiviral drugs".

Act

In order for bacteria to grow, they need a favorable nutrient medium (temperature, oxygen, moisture). Every housewife in her life is faced with these conditions when preserving food. Another example is the ancient practice of embalming the dead. Why do scientists find perfectly preserved mummies after many centuries? The answer is simple: antiseptics were already used then.

Before the concept of microbes was formed, attention was focused on preventing decay. Initially, the amount of the required agent was determined, as they say, "by eye". This method was imprecise, but experience, as you know, comes with time and practice. Today antiseptics are evaluated for their effect on clean culture of a certain type of microbes or spore and vegetative forms. To compare the strength of action, a phenol solution (aqueous) taken as a standard is used.

So, an antiseptic is an antiseptic disinfectant. Now let's figure out in which areas it is most often used.

Antiseptic in medicine

In this area, disinfection is especially important. Before the advent of modern high-quality antiseptics, “mechanical cleaning” was widely used, consisting in the opening of purulent formations. By the second half of the 18th century. Lister studied the "microbial theory of putrefaction" written by Louis Pasteur. Inspired by the idea, he soon published a paper on antiseptic principles in surgery.

Particular attention was paid to It was a new way of treating pustules and open fractures. Its essence was to apply bandages with a solution of this acid. Lister became the founder of antiseptics, which helps to effectively fight infection. Moreover, a 5% solution was applied to wounds, and a 2% solution was used for suture and dressing materials, operating fields, and hands.

Lister's antiseptic had not only supporters, but also ardent opponents. This was due to pronounced irritating and toxic effects both on the patient's tissue and on the hands of the surgeon himself. Therefore, work in this area continued intensively. A quarter of a century later, the aseptic method was discovered. The results of the discovery were impressive. And so much so that proposals were made to abandon antiseptics. However, this proved to be impossible. The work continued.

Soon, new ones, less toxic to the body, were proposed. Surgical instruments and objects surrounding the patient began to be treated with the same substances. Thus, antiseptic and aseptic are intertwined, and very tightly.

Types of antiseptics

Physical (dressing, application of drying powders, laser, ultraviolet rays).

Chemical. It is very important not only in the treatment of wound infections, but also in their prevention. Has a detrimental effect on microorganisms.

Biological. It is based on the use of a rather diverse and large group of drugs that affect both the microbial cell itself and its toxins, thereby increasing the defenses of the whole organism (bacteriophages, antibiotics, antitoxins (most often serums), proteolytic enzymes).

Mixed. The most common, includes several types at once (for example, primary treatment of wound surfaces (mechanical), and introduction (biological)).

The number of antiseptics today is enormous. But their application is almost always complex. In other words, the statement "an antiseptic is an antibiotic" is essentially correct. However, today's medicine cannot do without "additional support" in the form of wound treatment and disinfection of premises.

Now let's consider the most common antiseptics in medicine.

Alcohols

Ethanol, isopropyl, propyl. Concentration from 60% to 90%. They are used both in pure form and mixed. Allows you to disinfect the skin before injection and surgery. Often these alcohols are combined with iodine tincture or with cationic surfactants (chlorhexidine, benzalkonium chloride, octenidine dihydrochloride).

Ammonium compounds

Another common name is HOUR. Contains a range of chemicals (benzalkonium chloride (BAC), cetyltrimethylammonium bromide (CTMB), benzethonium chloride (BZT), cetylpyridinium chloride (CPC or Cetrim)). added to some disinfectants. Essential for treating the skin before surgery. Used to impregnate antiseptic towels. The antimicrobial effects of QAC are inactivated by anionic surfactants (eg soap).

Boric acid

It is added to suppositories intended for the treatment of the vagina from fungal infections. excellently fights against herpes virus attacks. Also added to burn creams and lens solutions.

Chlorgeskidine gluconate

Brilliant green

Popularly referred to as "brilliant green". A very common drug. Used to treat wounds, small abscesses. Has a detrimental effect on gram-positive bacteria.

Hydrogen peroxide

It is an antiseptic used to deodorize and cleanse ulcers and wounds. In everyday life, they are most often treated with scratches, umbilical cord. 6% and 3% solutions are available.

Iodine

Most often used in alcohol pre- and postoperative antiseptic. It is not recommended to disinfect small wounds with it, as it promotes scarring. Among the main advantages is its high antimicrobial activity. With prolonged exposure, it kills major pathogens, including spores of complex forms of microorganisms.

Means "Miramistin"

This is a new generation drug. Medication "Miramistin" is an antiseptic that is used in the treatment (or prevention) of infections of a fungal, viral and bacterial nature. Russian production. For the treatment of a number of infectious (colds) diseases, this particular antiseptic is often recommended. The reviews about him are mostly very positive. The drug is active against a wide range of microbes that cause inflammation and suppuration of wounds, sore throat, fungal diseases, chlamydia, herpes, etc. The activity of Miramistin does not depend on the location of the pathogen.

ASD

The second name is a stimulant antiseptic. Has pronounced antimicrobial and stimulating properties. Helps to increase the overall tone, reduces intoxication. It is active against staphylococci, tubercle bacillus, etc. It has a rather unpleasant pungent odor, therefore it is more often used for veterinary purposes.

Phenol

In the form of a solution, it is used to treat the doctor's hands immediately before the operation. Recommended for mouth and throat gargles. Phenol powder is sprinkled on the navel during healing. It has both antiseptic and analgesic effects.

Antiseptics outside of medicine

They are in demand in the food industry. As a rule, these are preservative antiseptics, most often acids (for example, the well-known acetic acid). It is thanks to them that it is possible to store canned food for a long time. Antiseptics are very actively used in construction. They are added to most paints and varnishes. This allows you to neutralize the saprophytic microflora. Wood antiseptic is a powerful weapon against blue stain, mold, rotting, fire. It also extends the shelf life of freshly cut trees.

The glazing antiseptic is especially in demand. What it is? This is the name of a drug that allows you to preserve the texture of wood and at the same time emphasizes its beauty. reduces the harmful effects of moisture, ultraviolet rays, temperature changes, and is effective against insects. Antiseptics are also used in everyday life. They are added to detergents, rooms are treated with them.

Antiseptics (antiseptics) are substances that destroy microorganisms or retard them or development.

Antiseptics are more or less active against all microorganisms, that is, unlike chemotherapeutic agents, they do not have selectivity of action. The action of antiseptic agents, leading to a delay in the development or reproduction of microorganisms, is called bacteriostatic, to their death. The latter effect can be called disinfectant. Some antiseptics can have both bacteriostatic and bactericidal effects, depending on their concentration and duration of action, the sensitivity of microorganisms to them, temperature, the presence of organic substances in the environment (pus, blood weaken the effect of a number of antiseptics).

Antiseptics are quite different in nature. There are the following groups. I. Halides:, iodine,. II. Oxidizing agents: potassium permanganate,. III. Acids:, salicylic. IV. :. V. Compounds of heavy metals:, (xeroform), copper,. Vi. (ethyl, etc.). Vii. :, lysoform,. VIII. :, lysol, phenol. IX. Tar, resins, petroleum products, mineral oils, synthetic, preparations (, tar, refined naphthalan oil,). X. Dyes:, methylene blue,. XI. Nitrofuran derivatives:. XII. 8-hydroxycholine derivatives:. XIII. Surfactants, or detergents: diocide. As antiseptic agents, they are also used for external use () and.

To characterize the antimicrobial activity of antiseptic agents, the phenol coefficient is used, which shows what is the strength of the antimicrobial action of this agent in comparison with phenol.

Antiseptics are used locally in the treatment of infected and long-term non-healing wounds or ulcers, phlegmon, mastitis, joint injuries, diseases of the mucous membranes, for washing the bladder, urethra, as well as for rooms, linen, objects, surgeon's hands, tools, disinfection of secretions ... Antiseptics are usually not used to treat common infections.

Contraindications to use, as well as a description of individual antiseptics - see the articles on the names of drugs [eg, etc.].

Antiseptics - antimicrobial agents used for local effects in the treatment of purulent, inflammatory and septic processes (infected and long-term non-healing wounds or ulcers, pressure sores, abscesses, phlegmons, mastitis, joint injuries, pyoderma, diseases of the mucous membranes), as well as for disinfection premises, linen, patient care items, surgeon's hands, tools, decontamination of secretions. These substances are usually not used to treat common infections.

Antiseptic agents act germistically, and in high concentrations they show a germicidal effect. Therefore, some antiseptics can be used as disinfectants (see). In addition, antiseptics are used for the preservation of medicines and food products. The antimicrobial activity of antiseptics is expressed using the phenol coefficient - the ratio of the bactericidal concentration of phenol to the bactericidal concentration of a given antiseptic.

The degree of effectiveness of antiseptics depends on a number of conditions: the sensitivity of the microorganism to it, the concentration of the antiseptic, the solvent in which it is used, the temperature, and the exposure time of the drug. Many antiseptics, to a greater or lesser extent, lose their activity in the presence of proteins, so it is advisable to use them only after cleansing the infected surfaces from exudate. Antiseptic agents act on all types of bacteria and other microorganisms, without showing the selectivity inherent in chemotherapeutic substances. Many antiseptics are capable of damaging living cells of a macroorganism. As a result, the assessment of antiseptics certainly includes the determination of their toxicity to humans and animals using the "toxicity index" - the ratio between the minimum concentration of the drug causing the death of the test microorganism within 10 minutes and the maximum concentration of the same drug that does not suppress the growth of chicken tissue culture. embryo. For medical practice, antiseptic agents are of the greatest value, which, all other things being equal, have the least toxicity.

Antiseptics are diverse in nature. They can be divided into the following groups. I. Halides: chlorine gas, bleach, chloramines, pantocid, antiformin, iodine, iodoform. II. Oxidants: hydrogen peroxide, potassium permanganate, berthollet's salt (potassium hypochlorous acid). III. Acids: sulfuric, chromic, boric, acetic, trichloroacetic, undecylenic, benzoic, salicylic, almond and some others. IV. Alkalis: calcium oxide, ammonia, soda, borax. V. Compounds of heavy metals: 1) mercury; 2) silver; 3) aluminum - basic aluminum acetate (Burov's liquid), alum; 4) lead - the main acetic acid lead (lead water); 5) bismuth - xeroform, dermatol, basic bismuth nitrate; 6) copper - copper sulfate, citrate copper; 7) zinc - zinc sulfate, zinc oxide. Vi. Alcohols: ethyl, isopropyl, trichloroisobutyl, some glycols. Vii. Aldehydes: formaldehyde, hexamethylenetetramine (urotropine). VIII. Phenols: phenol, or carbolic acid, cresol, creolin, parachlorophenol, pentachlorophenol, hexachlorophene, resorcinol, thymol, tricresol, phenyl salicylate (salol), benzonaphthol. IX. Products of dry distillation of organic materials: various resins and tar, ichthyol, albichtol. X. Colorants: brilliant green, rivanol, trypaflavin, methylene blue and gentian violet. XI. Nitrofuran derivatives: furacilin, furadonnn, furazolpdon. XII. Derivatives of 8-hydroxyquinoline: quinosol, yatren. XIII. Surfactants, or detergents. Distinguish between cationic, anionic and nonionic detergents. The most active are cationic detergents (for example, cetylpyridinium bromide). XIV. Antibiotics (see): gramicidin, neomycin, microcide, usnic acid. XV. Phytoncides (see): preparations of garlic, onions, St. John's wort, burnet, eucalyptus, etc.

The mechanism of action of antiseptics is different and is determined by their chemical and physicochemical properties. The antimicrobial action of acids, alkalis and salts depends on the degree of their dissociation: the more a compound dissociates, the more its activity. Alkalis hydrolyze proteins, saponify fats, and break down carbohydrates of microbial cells. The action of salts is also associated with a change in osmotic pressure and a violation of the permeability of cell membranes. Changes in the permeability of bacterial membranes are associated with the action of antiseptics, which lower surface tension (soaps, detergents). The action of heavy metal salts is explained by their ability to bind sulfhydryl groups of bacterial cell substances. The antiseptic effect of formaldehyde is due to its ability to denature proteins. Compounds of the phenol group have detergent properties and are capable of denaturing proteins. Oxidants cause the death of a microbial cell as a result of the oxidation of its constituent parts. The mechanism of action of chlorine and chlorine-containing compounds is associated with the formation of hypochlorous acid (HClO), which acts both as an oxidizing agent, releasing oxygen, and as a means of chlorinating amino and imino groups of proteins and other substances that make up microorganisms. The antimicrobial effect of dyes is associated with their ability to selectively react with certain acidic or basic groups of bacterial cell substances with the formation of poorly soluble, weakly ionizing complexes. The antimicrobial effect of nitrofuran derivatives is due to the presence of an aromatic nitro group in their molecule. Antiseptics inhibit the activity of many bacterial enzymes. For example, the bactericidal effect of antiseptics is closely related to their ability to inhibit the dehydration activity of bacteria. Under the influence of antiseptics, the process of cell division stops and morphological changes occur, accompanied by a violation of the cellular structure. Individual antiseptics - see related articles.

We give a brief description of the individual chemical classes of antiseptics and disinfectants.

1. Alcohols. Aliphatic alcohols, denaturing protein, have an antimicrobial effect to varying degrees.

Ethyl alcohol (wine alcohol)is a fermentation product of sugars. The State Pharmacopoeia provides for alcohol of the following concentrations: absolute alcohol contains at least 99.8 vol. %\u003e ethyl alcohol, ethyl alcohol 95% contains 95-96 vol. % ethyl alcohol, ethyl alcohol 90% - 92.7 parts of ethyl alcohol 95% and 7.3 parts of water, ethyl alcohol 70%) respectively 67.5 and 32.5 parts, ethyl alcohol 40% - 36 and 64 parts.

It is widely used in surgical practice for the treatment of the operating field, wounds, the surgeon's hands (70%), for alcohol compresses (40%), disinfection of instruments, suture material. 70% alcohol has an antiseptic effect, and 96%) is also tanning.

2. Halides... Chloramine -0.1-5% aqueous solution, contains active chlorine (25-29%), has an antiseptic effect. When interacting with tissues, active chlorine and oxygen are released, which determine the bactericidal properties of the drug. A solution of sodium hypochlorite is used, its 5% solution contains 0.1 g of active chlorine in 1 dm 3 and can be used for irrigation, cleaning and disinfection of contaminated wounds.

Iodine- an effective bactericidal substance. A solution containing iodine in a ratio of 1:20 000 causes the death of bacteria within 1 min, and spores - within 15 min, while the toxic effect on tissues is insignificant. Alcohol tincture of iodine contains 2% iodine and 2.4% sodium iodide, is the most effective antiseptic for treating the skin before surgery, venipuncture.

Iodinol- 1% solution. Antiseptic substance for external use. Used for washing wounds, rinsing the throat.

Iodonateand iodopyrone- organic compounds of iodine. A 1% solution is used. It is widely used as an antiseptic for the skin, especially during the preoperative preparation of the operating field.

Lugol's solution- contains iodine and potassium iodide, water and alcohol solutions can be used. The drug is of combined action. As a disinfectant it is used to sterilize catgut, as a chemotherapeutic agent - to treat thyroid diseases.

3. Heavy metals... Mercury oxycyanide- disinfectant. At concentrations of 1: 10,000, 1: 50,000, they are used for sterilizing optical instruments. Ammonium mercury ointment contains 5% active insoluble mercury compound, it is used for skin treatment and wound treatment as a disinfectant.

Silver nitrate- a solution of inorganic silver salts, has a pronounced bactericidal effect. 0.1-2% solution is used to wash the conjunctiva, mucous membranes; 2-5-10% solution - for lotions; 5-20% solutions have a pronounced cauterizing effect and are used to treat excess granulations.

Protargol, collargol (colloidal silver) -have pronounced bactericidal properties. Protein silver, containing 20% \u200b\u200bsilver, is used as a local antiseptic for treating mucous membranes. They have an astringent and anti-inflammatory effect. They are used for lubricating mucous membranes, washing the bladder for cystitis, urethritis, for washing purulent wounds, for sepsis, lymphangitis and erysipelas.

Zinc oxide- an antiseptic for external use, is part of many powders and pastes. It has an anti-inflammatory effect, prevents the development of macerations.

Copper sulfate -possesses pronounced antimicrobial properties.

4. Aldehydes... Formalin- 40% formaldehyde solution in water. Disinfectant. 0.5-5% solution is used to disinfect gloves, drains, instruments; 2-4% solution - for disinfection of patient care items. Dry formaldehyde is used for sterilizing optical instruments in gas sterilizers. 1-10% formalin solution causes the death of microorganisms and their spores within 1-6 hours.

Lysol- strong disinfectant. 2% solution is used for disinfection of care items, premises, soaking contaminated instruments. Currently, it is practically not used.

5. Phenols. Carbolic acid- has a pronounced disinfectant effect. It is used as part of a triple solution. To obtain an antimicrobial effect, at least a concentration of 1-2% is required, while at a concentration of 5% it already significantly irritates tissues.

Triple solution -contains 20 g of formalin, 10 g of carbolic acid, 30 g of soda and up to 1 liter of water. Strong disinfectant. Used for processing tools, care items, cold sterilization of cutting tools.

6. Dyes. Brilliant green- has a pronounced antimicrobial effect, especially against fungi and gram-positive bacteria (Pseudomonas aeruginosa, staphylococcus aureus), an antiseptic for external use. 1-2% alcohol (or water) solution is used to treat superficial wounds, abrasions, oral mucosa, pustular skin lesions.

Methylene blue -antiseptic agent against Escherichia coli, pyogenic microbes. 1-3% alcohol (or aqueous) solution is used to treat superficial wounds, abrasions, oral mucosa, skin, 0.02% aqueous solution - for washing wounds.

7. Acids.Boric acid -2.5% solution only inhibits the growth and reproduction of all types of bacteria. 2-4% solution is used for washing wounds, ulcers, rinsing the mouth.

Salicylic acid -antiseptic. It is used as a fungicide on leather. It has a keratolytic effect. It is used in the form of crystals (for tissue lysis), is a part of powders, ointments.

8. Alkalis. Ammonia alcohol- an antiseptic agent for external use. Previously, 0.5% aqueous ammonia solution was used to treat the hands of surgeons (Spasokukotsky-Kochergin method).

9. Oxidants.Hydrogen peroxide solution -contains 27.5-31% hydrogen peroxide, antimicrobial effect is due to oxidizing properties. 3% solution - the main drug for washing purulent wounds during dressings, rinsing, lotions, does not penetrate into the tissue. It is used for bleeding from mucous membranes and decaying cancerous tumors, etc. It is included in the composition of Pervomur and is an effective disinfectant ( 6% solution).

Potassium permanganate -belongs to strong oxidants, has a deodorizing and astringent effect. In the presence of organic substances, especially the products of decay and fermentation, it splits off atomic oxygen with the formation of manganese oxides, which is the reason for the antiseptic effect. It is used in the form of 0.02-0.1-0.5% solutions for washing wounds.

10. Detergents (surfactants).Chlorhexidine bigluconate- an antiseptic agent that acts on gram-positive microbes and Escherichia coli. 0.5% alcohol solution is used to treat the hands of the surgeon and the operating field. 0.1-0.2% aqueous solution - one of the main drugs for washing wounds and mucous membranes, treating purulent wounds. It is part of solutions for the treatment of hands and the surgical field (plivasept, AHD-special). Antiseptic soap with the addition of chlorhexidine is used to treat the hands of the surgeon and the operating field. The systematic use of chlorhexidine-containing soap leads to the accumulation of this substance on the skin and to the accumulation of antimicrobial action.

Zerigel- an antiseptic agent for external use. It is used for treatment (film-forming antiseptic) of the hands and the operating field.

Degmin, degmicide -antiseptic agents for external use. Used to treat hands and the surgical field.

11. Derivatives of nitrofuran... Furacilin -antimicrobial agent acting on various gram-positive and gram-negative microbes. An aqueous 0.02% solution (1: 5000) is used to treat purulent wounds, ulcers, bedsores, burns. An alcoholic (1: 1500) rinse solution can be used, as well as an ointment containing 0.2% of the active substance. Does not interfere with the wound healing process.

Lifusol- contains furacilin, linetol, resins, acetone (aerosol). Antiseptic agent for external use. It is applied in the form of a film. It is used to protect postoperative wounds and drainage holes from exogenous infection and to treat superficial wounds.

Furadonin, furagin, furazolidone- have a wide antimicrobial spectrum of action. In addition to urinary tract infections, they are used in the treatment of intestinal infections (dysentery, typhoid fever).

12. Derivatives of 8-hydroxyquinoline... Nitroxoline (5-NOK) -a chemotherapeutic agent, "uroantiseptic". It is used to treat urinary tract infections.

Enteroseptol, Intestopan- chemotherapeutic agents used for intestinal infections.

13. Quinoxaline derivatives... Dioxidine- an antiseptic agent for external use. 0.1-1% aqueous solution is used for washing purulent wounds, mucous membranes, especially when antibiotics and other antiseptics are ineffective. With sepsis and severe infections, intravenous drip can also be administered.

14. Derivatives of nitroimidazole. Metronidazole (metragil, flagil, trichopolum) -a broad-spectrum chemotherapeutic agent. Effective against protozoa, bacteroids and a number of anaerobes.

15. Tar, tar... Tar birch- product of dry distillation of pine trunks and branches or pure selected birch bark. It is a mixture of aromatic hydrocarbons: benzene, toluene, phenol, creols, resins and other substances. It is used in the form of 10-30% ointments, pastes, liniment, it is part of Vishnevsky's balsamic ointment (tar - 3 parts, xeroform - 3 parts, castor oil - 100 parts), used to treat wounds, ulcers, bedsores, burns, frostbites. When applied topically, it has a disinfectant effect, improves blood circulation and stimulates tissue regeneration.

Currently, preparations based on birch tar are used much less frequently.

16. Quinolones (nalidixic acid, pipemidic acid, oxolinic acid).The mechanism of their action is associated with the ability to inhibit the synthesis of bacterial DNA by inhibiting the activity of enzymes of the microbial cell.

Fluoroquinolones (ciprofloxacin, ofloxacin, norfloxacinand others) - are active against gram-positive microbes, highly active against enterobacteria, mycobacterium tuberculosis. They are used mainly for infections of the intestines, abdominal cavity and small pelvis, skin and soft tissues, sepsis.

17. Sulfonamides (sulfadiazine, sulfadimezine, sulfadimethoxin, sulfamonomethoxin, sulfamethoxazole, sulfalene). They disrupt the synthesis of folic acid by a microbial cell and act bacteriostatically on gram-positive and gram-negative bacteria, chlamydia, toxoplasma. Combined preparations of sulfonamides with trimethoprim (bactrim, biseptol, septrin, sulfaton) are widely used in clinical practice to treat bacterial infections of various localizations.

18. Antifungal agents. There are drugs of the polyene series: nystatin, levorin, amphotericin B; imidazole series: clotrimazole, miconazole, bifonazole; triazole series: fluconazole, itraconazole; and others: griseofulvin, flucytosine, nitrofungin, decamine.

They act on yeast-like fungi of the genus Candida, dermatophytosis. They are used to prevent complications and treat fungal diseases (simultaneously with broad-spectrum antibiotics).

19. Plant antiseptics.Phytoncides, chlorophyllipt, ektericid, baliz, calendula - are mainly used as antiseptic agents for external use for washing superficial wounds, mucous membranes, skin treatment. They have anti-inflammatory effects.

Bacteriophages(bacterium + Greek phagos - devouring, synonym: phage, bacterial virus) - a virus capable of infecting a microbial cell, reproducing in it, forming numerous offspring and causing lysis of a bacterial cell. Antistaphylococcal, antistreptococcal and anti-coli bacteriophages are used mainly for washing and treating purulent wounds and cavities after identification of the pathogen.

Antitoxins- specific antibodies formed in the human and animal body under the influence of toxins, microbes, plant and animal poisons, which have the ability to neutralize toxic properties. Antitoxins play a protective role in toxinemic infections (tetanus, diphtheria, gas gangrene, some staphylococcal and streptococcal diseases).

Immunoglobulin preparations- γ-globulins - purified γ-globulin fraction of human serogenic proteins, containing in concentrated form antibodies against measles, influenza, poliomyelitis virus, tetanus γ-globulin, as well as increased concentrations of antibodies against certain infectious agents or toxins secreted by them.

Antistaphylococcal hyperimmune plasma- has a pronounced specificity due to the high content of antibodies to antigens with which donors were immunized. It is highly effective in the prevention and treatment of purulent septic diseases caused by staphylococcus. Antipseudomonal hyperimmune plasma is also used.

Proteolytic enzymes(trypsin, chimotpsin, chymoxin, terrilitin, iruksol) - when applied locally, they cause lysis of necrotic tissues and fibrin in the wound, dilute purulent exudate, and have an anti-inflammatory effect.

Biological antiseptics also includes methods for increasing the non-specific and specific resistance of the organism.

Non-specific resistance and non-specific immunity can be influenced in the following ways:

Ultraviolet and laser irradiation of blood (phagocytosis, complement system, oxygen transport are activated);

The use of a suspension of cells and xenoperfusate of the spleen, perfusion through the whole or fragmented spleen (pigs), while counting on the action of lymphocytes and cytokines contained in the spleen tissue;

Transfusion of blood and its components;

The use of a complex of vitamins, antioxidants, biostimulants;

The use of thymalin, T-activin, prodigiosan, levamisole (stimulate phagocytosis, regulate the ratio of T- and B-lymphocytes, increase the bactericidal activity of the blood), interferons, interleukins, roncoleukin, roferon, etc. (have a pronounced activating targeted effect on immunity).

Antibiotics- substances that are products of the vital activity of microorganisms (natural antibiotics), suppressing the growth and development of certain groups of other microorganisms. Chemical derivatives of natural antibiotics (semi-synthetic antibiotics) are also isolated.

The main groups of antibiotics:

1. B-Lactam antibiotics:

1.1. Natural penicillins;

Semi-synthetic penicillins:

Penicillins resistant to penicillinase;

Aminopenicillins;

Carboxypenicillins;

Ureidopenicillins;

B-lactamase inhibitors;

1.2. Cephalosporins:

1st generation;

2nd generation;

III generation;

IV generation.

2. Antibiotics of other groups:

Carbapenems;

Aminoglycosides;

Tetracyclines;

Macrolides;

Lincosamides;

Glycopeptides;

Chloramphenicol;

Rifampicin;

Polymyxins.

Penicillins -all drugs of this group act bactericidal, their mechanism of action is the ability to penetrate the cell membrane of microbes and bind to "penicillin-binding proteins", as a result, the structure of the cell wall of the microbe is disrupted.

Natural penicillins.These include:

Benzylpenicillin (penicillin C);

Procainepenicillin (novocaine salt of penicillin O);

Benzatinpenicillin (Bicillin);

Phenoxymethylpenicillin (penicillin V).

These antibiotics are active against streptococci of groups A, B, C, pneumococci, gram-negative microorganisms (gonococci, meningococci), as well as some anaerobes (clostridia, fusobacteria) and are inactive against enterococci. Most staphylococcal strains (85-95%) produce B-lactamases and are resistant to the action of natural penicillins.

Penicillins resistant to penicillinase:

Methicillin;

Oxacillin;

Cloxacillin;

Flucloxacillin;

Dicloxacillin.

The spectrum of antimicrobial action of these drugs is similar to the spectrum of action of natural penicillins, but they are inferior to them in antimicrobial activity. The advantage of these drugs is their stability against staphylococcal B-lactamases, and therefore they are considered the drugs of choice in the treatment of staphylococcal infection.

Aminopenicillins:

Ampicillin;

Amoxicillin;

Bacampicillin;

Pivampicillin.

They are characterized by a wide spectrum of antimicrobial action. Highly active against some gram-negative bacteria, mainly of the intestinal group (Escherichia coli, Proteus, Salmonella, Shigella, Haemophilus influenzae). Bacampicillin and pivampicillin are ampicillin esters, which, after absorption in the intestine, are de-esterified and converted to ampicillin, are absorbed better than ampicillin, and create high blood concentrations after taking the same doses.

Aptispseudomonal penicillins:

Carboxypenicillins (carbenicillin, ticarcillin);

Ureidopenicillins (piperacillin, azlocillin, mezlocillin). This group has a wide spectrum of action on gram-positive cocci, gram-negative bacilli, anaerobes.

Preparations containing penicillins and B-lactamase inhibitors:

Ampicillin and sulbactam - unazine;

Amoxicillin and clavulanic acid - amoxiclav, augmentin;

Ticarcillin and clavulanic acid - tymentin;

Piperacillin and tazobactam - tazocin.

These drugs are fixed combinations of broad-spectrum penicillins with B-lactamase inhibitors. They have the property of irreversibly inactivating a wide range of B-lactamases - enzymes produced by many microorganisms (staphylococci, enterococci, Escherichia coli), bind enzymes and protect the broad spectrum penicillins contained in their composition from the action of B-lactamases. As a result, microorganisms resistant to them become sensitive to the combination of these drugs.

Cephalosporins of I, II, III and IV generations.They rank first among antibacterial agents in terms of frequency of use in inpatients. They have a wide spectrum of antimicrobial action, which covers almost all microorganisms, with the exception of enterococci. They have a bactericidal effect, have a low frequency of resistance, are well tolerated by patients and rarely cause side effects.

Their classification is based on the spectrum of antimicrobial activity. In clinical practice, the most commonly used cephalosporins of the I, II and III generations. In recent years, two drugs have appeared, which, on the basis of antimicrobial properties, have been attributed to IV generation cephalosporins.

Generation I cephalosporins - cephaloridin, cephalothin, cefapirin, cefradine, cefazolin, cephalexin.

II generation cephalosporins - cefamandol, cefuroxime, cefoxitin, cefmetazole, cefotenan. They have a wider spectrum of action than drugs of the 1st generation.

Third generation cephalosporins - cefotaxime, cefodizime, cefoperazone, ceftibuten, cefixime, latamoxef, etc. Some drugs are active against Pseudomonas aeruginosa.

Cefodizim -the only cephalosporin antibiotic that has an immunostimulating effect.

They are widely used for the treatment of nosocomial infections.

IV generation cephalosporins - cefpirome, cefepime - have a wider spectrum of action compared to III generation cephalosporins. Their high clinical efficacy has been established in the treatment of various nosocomial infections.

Carbapenems.Carbapenems (imipenem, meropenem) and combined carbapenem thienam (imipenem + sodium cilastatin) are characterized by the widest spectrum of antibacterial activity. They are used to treat severe infections, mainly hospital ones, especially with an unknown causative agent of the disease. The wide spectrum and high bactericidal activity allow using these drugs as monotherapy, even in the treatment of life-threatening infections.

Aminoglycosides.All of them act only on extracellular microorganisms. There are three generations of aminoglycosides, but only II generation (gentamicin) and III (sisomycin, amikacin, tobramycin, netilmicin) aminoglycosides are used.

Tetracyclines.They inhibit protein synthesis in a microbial cell, have high activity against gram-positive and gram-negative microorganisms (aerobic and anaerobic), chlamydia, rickettsia, cholera vibrio, spirochetes, actinomycetes. The most active drugs are doxycycline and minocycline.

Doxycycline circulates in the body for a long time and is well absorbed (95%) when taken orally.

Macrolides(erythromycin, clarithromycin, spiramycin, azithromycin, midecamycin). The spectrum of their action is similar to that of natural penicillins. Depending on the type of microorganism and the concentration of the antibiotic, macrolides act bactericidal or bacteriostatic. They are the drugs of choice in the treatment of croupous pneumonia, atypical pneumonia, streptococcal infections (tonsillitis, erysipelas, pharyngitis, scarlet fever).

Lincosamides(lincomycin, clindamycin). The mechanism of action of lincosamides is to suppress the protein synthesis of bacteria. They are active against anaerobes, staphylococci and streptococci. They are the drugs of choice in the treatment of infections caused by anaerobic microorganisms (infection of the abdominal cavity and small pelvis, endometritis, lung abscesses and other localization). As an alternative agent, they are used for staphylococcal infections.

Glycopeptides(vancomycin, teicoplanin). Disrupt the synthesis of the cell wall of bacteria, have a bactericidal effect. Active against streptococci, pneumococci, enterococci, corynebacteria.

Chloramphenicol.Broad-spectrum antibiotic. It is active against gram-positive cocci (staphylococci, streptococci, pneumococci, enterococci), some gram-negative bacteria (colibacillus, hemophilus influenzae), anaerobes, rickettsia.

Rifampicin.The mechanism of action is associated with the suppression of RNA synthesis in the microbial cell. It is active against mycobacterium tuberculosis, gonococci, meningococci.

Polymyxins[polymyxin B, polymyxin E (calistin)]. The mechanism of action is associated with damage to the cytoplasmic membrane of the microbial cell. They are used only in cases of severe gram-negative infection (Pseudomonas aeruginosa, Klebsiella, Enterobacter) with resistance to all other antibacterial agents.

Antiseptics (antiseptics)

Antiseptic (from the Greek "against decay") is called antimicrobial agents that delay the development of microorganisms, and disinfectants are substances that kill microbes. Accordingly, a bacteriostatic effect is distinguished, when the development of microorganisms stops, and a bactericidal effect, when microorganisms are completely killed.

It is easy to see that there is no fundamental difference between antiseptic and disinfectant substances, as well as bacteriostatic and bactericidal action, since any antimicrobial agent, depending on the conditions of its use, in some cases can cause a delay in the development of microorganisms, and in others - its death. A large number of different antiseptics can be classified according to many criteria. According to the methods of application, agents for antiseptic effects on the skin, mucous membranes of the gastrointestinal tract, respiratory, urinary tract, etc. are distinguished.

By chemical structureantiseptics are classified according to the classes of chemical compounds to which they belong, which reflects the mechanism of their action. This is a group of halogens (antiformin, iodoform, iodinol), oxidants (hydrogen peroxide, potassium permanganate), acids (salicylic, benzoic, boric), alkalis (ammonia), aldehydes (formalin, lysoform), alcohols (ethyl), heavy metal salts (preparations of mercury, silver, copper, zinc, lead), phenols (carbolic acid, lysol, resorcinol), dyes (methylene blue, brilliant green), soaps (green), tar, resins, petroleum products (ASD, ichthyol, oil naphthalan, ozokerite), phytoncidal and other herbal antibacterial drugs (urzalin, calendula tincture, imanin).

Antiseptics. Halogen group:

Chloramine B. White or slightly yellowish powder with a slight chlorine odor. Let's dissolve in water, alcohol, contains 25-29% of active chlorine. Has an antiseptic effect. Used in the treatment of infected wounds (washing, wetting tampons and napkins with 1-2% solutions), hand disinfection (0.25-0.5%), and disinfection of non-metallic instruments. For disinfection of care items and secretions for typhoid, paratyphoid, cholera and other infections of the intestinal group and for droplet infections (scarlet fever, diphtheria, influenza, etc.), 1-2-3% solutions are used, for tuberculosis infection - 5%.

Pantocid, release form - tablets, each containing 3 mg of active chlorine. Used as an antiseptic for hand disinfection (1-1.5% solutions), douching and wound treatment (0.10.5%), for water disinfection (1-2 tablets per 0.5-0.75 l of water), which occurs within 15 minutes.

Iodine- is obtained from seaweed ash and oil drilling waters.

There are 4 groups of iodine preparations:

inorganic iodides (potassium iodide, sodium iodide);

organic substances that split off elemental iodine (iodoform, iodinol);

Being absorbed, iodine as an antiseptic has an active effect on metabolism, especially on the function of the thyroid gland. The body's daily requirement for iodine is 200-220 mcg. Iodine is excreted from the body mainly by the kidneys, partly by the gastrointestinal tract, sweat and mammary glands.

Inside, iodine preparations are used as an expectorant (increase the secretion of mucus by the glands of the respiratory tract), with atherosclerosis, tertiary syphilis, hypothyroidism, for the prevention and treatment of endemic goiter, and chronic poisoning with mercury and lead. With prolonged use of iodine preparations and hypersensitivity to them, the phenomena of iodism are possible (runny nose, urticaria, salivation, lacrimation, rash).

Contraindications for taking iodine preparations inside are: pulmonary tuberculosis, nephritis, nephrosis, furunculosis, chronic pyoderma, hemorrhagic diathesis, pregnancy.

Outwardly, iodine solutions are used as an antimicrobial antiseptic for treating wounds, preparing the operating field, etc.; having an irritating effect, they can cause reflex changes in the activity of the body.

Alcohol iodine solution - 5% or 10%, used externally as an antiseptic, irritant and distracting agent for inflammatory and other diseases of the skin and mucous membranes. As a distraction used for myositis, neuralgia.

Lugol's solution. Iodine in an aqueous solution of potassium iodide - composition: iodine 1 part, potassium iodide 2 parts, water 17 parts. Lugol's solution with glycerin - composition: iodine 1 part, potassium iodide 2 parts, glycerin 94 parts, water 3 parts. Used to lubricate the mucous membranes of the pharynx, larynx as an antiseptic.

Iodoform. Applied externally as an antiseptic agent in the form of powders, ointments for the treatment of infected wounds, ulcers.

Iodinol, is a product of the addition of iodine to polyvinyl alcohol, which slows down the release of iodine and lengthens its interaction with body tissues, while simultaneously reducing the irritating effect of iodine on them. Applied for chronic tonsillitis, purulent otitis media, chronic periodontitis, purulent surgical diseases, trophic and varicose ulcers, thermal and chemical burns.

In chronic tonsillitis, the lacunae of the tonsils are washed (4-5 washes at intervals of 2-3 days), with purulent otitis media, instillation (5-8 drops) and rinsing are used. With trophic and varicose ulcers, gauze napkins (in 3 layers) moistened with iodinol are applied to the surface of the ulcer (pre-wash the skin with warm water and soap and lubricate the skin around the ulcer with zinc ointment). The dressing is done 1-2 times a day, and the gauze lying on the surface of the ulcer is not removed, but only re-soaked with iodinol. After 4-7 days, a local bath is prescribed, after which the treatment is continued again. For purulent and infected burns, apply a loose gauze bandage soaked in the drug. With fresh thermal and chemical burns of I-II degrees, a gauze bandage soaked in iodinol is also applied, the inner layer is irrigated as needed. When using iodinol, iodism phenomena can be observed.

Iodonate, an aqueous solution of a complex of surfactant with iodine (3%). It is used as an antiseptic for disinfecting the skin of the operating field, the drug has a high bactericidal activity

Antiseptics. Oxidants:

Hydrogen peroxide (perhydrol) - two drugs are produced, representing a solution of hydrogen peroxide in water: a solution of hydrogen peroxide 3% and a solution of hydrogen peroxide 27.5-31% (concentrated). Both preparations are clear, colorless liquids with a faint peculiar odor. Upon contact with organic substances and alkalis, hydrogen peroxide decomposes with the release of gaseous oxygen, which has antiseptic properties and promotes mechanical cleaning of tissues. It is used as an antiseptic for rinsing and washing with angina, stomatitis, otitis media, as well as when treating wounds in solutions at the rate of 1 teaspoon or 1 tablespoon of 3% solution per glass of water.

Hydroperite - antiseptic tablets containing a complex compound of hydrogen peroxide with urea. The hydrogen peroxide content is about 35%. White tablets, easily soluble in water, weight 1.5 g. Used as an antiseptic instead of hydrogen peroxide. To obtain a solution corresponding to approximately 1% hydrogen peroxide solution, dissolve 2 tablets in 100 ml of water. One tablet corresponds to 15 ml (1 tablespoon) of 3% hydrogen peroxide solution. For gargling, dissolve one tablet in a glass of water.

Potassium permanganate (potassium permanganate, "potassium permanganate"), dark or red-violet crystals with a metallic luster, soluble in water. It is a strong oxidizing agent, which determines its antiseptic properties. Used in aqueous solutions for rinsing the mouth and throat (0.020.1%), for lubricating burn and ulcerative surfaces (2-5%), for washing wounds (0.1-0.5%), for douching for gynecological and urological diseases (0.02-0.1%), at the same concentration for gastric lavage in some poisoning as an antiseptic.

Antiseptics. Acids:

Salicylic acid, white, small, odorless needle crystals. Slightly soluble in cold water, soluble in hot water, easily in alcohol. Applied externally as an antiseptic agent in powders (2-5%) and 1-10% ointments, pastes, alcohol solutions for lubricating the skin (salicylic alcohol), rubbing in the area of \u200b\u200binflamed joints, for wiping the skin - with itching, seborrhea. It is produced ready-made under the name "Corn liquid" and "Corn plaster" (salicylic acid 20 parts, rosin 27 parts, paraffin 26 parts, petrolatum 27 parts), Galmanin powder containing salicylic acid, zinc oxide (10 parts) talc and starch , Lassar pasta,

Camfocin (salicylic acid, castor oil, turpentine, methyl ether, camphor, tincture of capsicum) - for rubbing in rheumatism, arthritis as an antiseptic.

Boric acid, shiny, slightly oily scales, soluble in cold water and alcohol. It is used in the form of ointments and in powders for antiseptic action in case of skin diseases (baby powder "Bolus"), a paste called "Bornozinc-naphthalan" is produced in finished form.

Boric Vaseline - contains boric acid 5 parts, petroleum jelly 95 parts. Applied externally as an antiseptic.

Boric alcohol, contains 0.5-5 g of boric acid, ethyl alcohol 70%. Apply this antiseptic in the form of ear drops 3-4 drops 2-3 times a day.

Pasta Teymurov - contains boric and salicylic acid, zinc oxide, formalin, lead acetate, talc, glycerin, mint oil. It is used as a disinfectant, drying and deodorizing agent for sweating, diaper rash of the skin.

Antiseptics. Alkalis

Sodium borate(borax, sodium boric acid), colorless crystalline powder. Used externally as an antiseptic for douching, rinsing, lubrication.

Bicarmint, tablets containing sodium borate 0.4 g, sodium bicarbonate 0.4 g, sodium chloride 0.2 g, menthol 0.004 g. Applied as an antiseptic externally as an antiseptic and anti-inflammatory agent for rinsing, rinsing, inhalations in inflammatory processes of the upper respiratory ways. Dissolve 1-2 tablets in 1/2 glass of water.

Ammonia (ammonia solution), 10% ammonia solution in water. Transparent, colorless liquid with a strong ammonia odor. Used in surgery for washing hands and for inhalation in case of fainting and intoxication with alcohol.

Antiseptics. Aldehydes

Formaldehyde

(formalin), a clear, colorless liquid with a peculiar pungent odor. It is used as an antiseptic as a disinfectant and deodorizing agent for washing hands, washing the skin with excessive sweating (0.5-1%), for disinfecting instruments (0.5%), for douching (1: 2000 - 1: 3000). Part of the lysoform. Formidron is a liquid containing a solution of formaldehyde 10 parts, ethyl alcohol 95% 40 parts, water 50 parts, cologne 0.5 parts. Used to wipe the skin with excessive sweating.

Formaldehyde ointment, white with a faint smell of formalin and fragrance. Applied with increased sweating, rubbed into the armpits once a day, into the interdigital folds.

Lysoform, formaldehyde soap solution. Ingredients: formalin 40 parts, potassium soap 40 parts, alcohol 20 parts. It has a disinfecting and deodorizing effect. Used as an antiseptic for douching in gynecological practice, for hand disinfection (1-3% solutions).

Urotropin (hexamethylenetetramine), colorless, odorless crystals, readily soluble in water. Aqueous solutions are alkaline. It is used mainly for infectious processes of the urinary tract (cystitis, pyelitis). The action of the antiseptic is based on the ability of the drug to decompose in an acidic environment with the formation of formaldehyde. The drug is prescribed on an empty stomach. Indications for its use are cholecystitis, cholangitis, allergic diseases of the skin, eyes (keratitis, iridocyclitis, etc.). The drug can cause irritation of the renal parenchyma, with these signs the drug is stopped.

Urosal, tablets containing 0.3 g of hexamethylenetetramine and phenyl salicylate.

Calceks - tablets of white color, salty-bitter taste, easily soluble in water. Contains 0.5 g of a complex salt of hexamethylenetetramine and calcium chloride. Apply 1-2 tablets 3-4 times a day for colds as an antiseptic. Tsiminal, suppresses (locally) gram-positive and gram-negative bacteria, promotes epithelialization and wound healing. Used externally in the treatment of wounds, pyoderma, trophic ulcers, burns. Assign in the form of a powder (for dusting) or 1-3% suspension, which is applied to the damaged surface, dressings after 3-4 days. With prolonged use of the drug, dermatitis, burning sensation and itching may occur.

Ethanol (wine alcohol), according to its pharmacological properties, are classified as narcotic substances. Acting on the cerebral cortex, it causes a characteristic alcoholic arousal associated with a weakening of inhibition processes. In medical practice, it is used mainly as an external antiseptic and irritant for rubbing, compresses, etc. It is sometimes administered intravenously with gangrene and lung abscess in sterile isotonic solution. Ethyl alcohol is widely used for the manufacture of tinctures, extracts and dosage forms for external use.

Antiseptics. Heavy metal salts

Sublimate (mercury dichloride),

heavy white powder, highly active antiseptic and highly toxic. Great care must be taken when working with it. Do not allow the drug and its solutions to get into the oral cavity, mucous membranes and skin. Solutions can be absorbed and cause poisoning. Mercury dichloride is used in solutions (1: 1000 - 2: 1000) for disinfection of linen, clothes, for washing walls, patient care items, for disinfection of the skin. They are also used in the treatment of skin diseases.

Mercury white ointment, it is used as an antiseptic and anti-inflammatory for skin diseases (pyoderma, etc.).

Calomel (mercury monochloride), used externally in the form of ointments for diseases of the cornea, blennorrhea as an antiseptic. It has a toxic effect on the body, therefore, at the present time, as a laxative, diuretic and choleretic, it does not matter, it is used only externally.

Diocide, is a good detergent and antibacterial agent. Possesses bactericidal activity against various bacteria and bacterial spores, as well as fungistatic activity against fungi and mold. It is used as a sterilizing agent for washing the hands of surgeons before surgery, cold sterilization of equipment (artificial blood circulation), surgical instruments. Silver nitrate (lapis) - in small concentrations has an astringent and anti-inflammatory effect, in stronger solutions - cauterizes tissues, bactericidal. Applied externally for erosions, ulcers, excessive granulations, acute conjunctivitis. In chronic gastritis, it is prescribed internally in the form of a solution or pills. To prevent blenorrhea, newborns immediately after birth are instilled into the eyes of a 2% solution of silver nitrate.

Collargol, colloidal silver. Applied for washing purulent wounds (0.2-1%), for washing the bladder with cystitis (1-2%), purulent conjunctivitis and blennorrhea for antiseptic action.

Copper sulfate (copper sulfate, copper sulfate), blue crystals, readily soluble in water. It is used as an antiseptic for conjunctivitis, for washing with urethritis and vaginitis (0.25%). In case of skin burns, the burned area is abundantly moistened with phosphorus with a 5% solution of copper sulfate. In case of poisoning with white phosphorus, taken internally, appoint 0.3-0.5 g of copper sulfate per 1/2 cup of warm water and gastric lavage with a 0.1% solution.

Simple lead plaster, contains in equal amounts a mixture of lead oxide, pork fat and sunflower oil with the addition of water to form a plastic mass. It is used for purulent-inflammatory skin processes, boils, carbuncles as an antiseptic.

Zinc oxide used externally as an astringent and disinfectant for skin diseases as an antiseptic.

Zinc ointment, composition: zinc oxide 1 part, petroleum jelly 9 parts.

Lassar pasta, contains: salicylic acid 2 parts, zinc oxide and starch 25 parts each, petroleum jelly 48 parts.

Galmanin, contains: salicylic acid 2 parts, zinc oxide 10 parts, talc and starch 44 parts. Used for sweating feet as an antiseptic.

Neoanuzole, candles, composition: bismuth nitrate, iodine, tannin, zinc oxide, resorcinol, methylene blue, fatty base. Used for cracks and hemorrhoids of the anus as an antiseptic.

Antiseptics. Phenols

Phenol, carbolic acid. Obtained by the distillation of coal tar. Phenol is pure, the solution has a strong bactericidal effect. Used for disinfection of household and hospital items, tools, linen, secretions. For disinfection of premises, a soap-carbolic solution is used. In medical practice, phenol is used for certain skin diseases (sycosis, etc.) and for inflammation of the middle ear (ear drops). Phenol has an irritating and cauterizing effect on the skin and mucous membranes, it is easily absorbed through them and can be toxic in large doses (dizziness, weakness, respiratory distress, collapse).

Lysol, made from technically pure cresol and green potash soap. Used to disinfect the skin as an antiseptic.

Resorcinol, used for skin diseases (eczema, seborrhea, itching, fungal diseases) externally in the form of solutions (water and alcohol) and ointments. Benzonaphthol, antiseptic for diseases of the gastrointestinal tract. Adults are prescribed 0.3-0.5 g 3-4 times a day as an antiseptic. Children under 1 year old - 0.05 g per appointment, under 2 years old - 0.1 g, 3-4 years old - 0.15 g, 5-6 years old - 0.2 g, 7 years old - 0.25 g, 8 -14 years - 0.3 g.

Antiseptics. Dyes

Methylene blue, soluble in water (1:30), difficult in alcohol, aqueous solution is blue. Used as an antiseptic externally for burns, pyoderma, folliculitis, etc. In cystitis, urethritis, wash with aqueous solutions (0.02%). Methylene blue solutions are injected into a vein for poisoning with cyanides, carbon monoxide, hydrogen sulfide.

Brilliant green golden-green powder, hardly soluble in water and alcohol. Applied as an antiseptic externally as an antiseptic in the form of 0.1-2% alcohol or aqueous solution for pyoderma, blepharitis to lubricate the edges of the eyelids.

Antiseptic liquid Novikov, composition: tannin 1 part, brilliant green 0.2 parts, alcohol 95% 0.2 parts, castor oil 0.5 parts, collodion 20 parts. Colloidal mass that dries quickly and forms an elastic film on the skin. It is used as an antiseptic for treating minor skin lesions. You can not use the liquid with extensive bleeding, infected wounds.

Rivanol(ethacridine lactate), yellow crystalline powder of bitter taste, odorless. It is slightly soluble in cold water, alcohol, water solutions are unstable in the light, become brown in color. You should use freshly prepared solutions. They have an antimicrobial effect, mainly in infections caused by cocci, especially streptococci. The drug is slightly toxic, does not cause tissue irritation. It is used as an external preventive and therapeutic agent in surgery, gynecology, urology, ophthalmology, otolaryngology. For the treatment of fresh and infected wounds, aqueous solutions of 0.05% are used, for washing the pleural and abdominal cavities with purulent pleurisy and peritonitis, as well as with purulent arthritis and cystitis - 0.5-0.1%. With boils, carbuncles, abscesses, 0.1-0.2% solutions are prescribed in the form of lotions, tampons. For washing the uterus in the postpartum period, use a 0.1% solution, with coccal conjunctivitis - 0.1% in the form of eye drops. In case of inflammation of the mucous membranes of the mouth, pharynx, nose - rinsing with a 0.1% solution or lubrication with a 1% solution. In dermatology, it is used as an antiseptic of various concentrations of ointments, powders, and pastes.

Konkov ointment, composition: ethacridine 0.3 g, fish oil 33.5 g, bee honey 62 g, birch tar 3 g, distilled water 1.2 g

Antiseptics. Tar, resins, petroleum products, herbal balms

Tar birch - a product of processing the outer part of birch bark. Thick oily liquid, contains phenol, toluene, xylene, resins and other substances. Applied externally in the treatment of skin diseases in the form of 10-30% ointments, liniment. The therapeutic effect as an antiseptic arises not only as a result of local action (improved blood supply to tissues, increased keratinization processes), but also in connection with reactions arising from irritation of skin receptors. As an integral part, it is included in Wilkinson's, Vishnevsky's and others' ointments. With prolonged use of tar, skin irritation and exacerbation of the eczematous process may occur.

Vishnevsky balm - composition: tar 3 parts, xeroform 3 parts, castor oil 94 parts. It is used in the treatment of wounds, ulcers, bedsores, etc. It has antiseptic properties, has a weak irritant effect, and promotes the regeneration process. Wilkinson's ointment - liquid tar 15 parts, calcium carbonate (precipitated chalk) 10 parts, purified sulfur 15 parts, naftalan ointment 30 parts, green soap 30 parts, water 4 parts. Applied as an antiseptic externally as an antiseptic for scabies and fungal skin diseases.

ASD drugare obtained from animal tissues. The action is similar to tar, but has a less dramatic effect on the skin. It is used as an antiseptic in the treatment of eczema; in the first hours it can cause itching and burning.

Forest liquid, a product of heat treatment (dry distillation) of certain tree species (hazel and alder). It is used as an antiseptic for eczema, neurodermatitis and other skin diseases.

Ichthyol - ammonium salt of shale oil sulfonic acids. Almost black syrupy liquid, contains 10.5% of bound sulfur. It has anti-inflammatory, local anesthetic and antiseptic properties. It is used as an antiseptic for skin diseases, neuralgia, arthritis, etc. in the form of an ointment or water-alcohol lotions. For diseases of the pelvic organs (prostatitis, metritis, etc.), ichthyol suppositories or tampons moistened with a 10% glycerin solution of ichthyol are prescribed.

Naphthalene ointment - a complex mixture of hydrocarbons and resins - Naftalan oil (70 parts) and paraffin (18 parts) with petrolatum (12 parts). Naftalan oil and its preparations, when exposed to skin and mucous membranes, have a softening, absorbing, disinfecting and some analgesic effect. It is used externally as an antiseptic for various skin diseases, inflammation of the joints and muscles (arthritis, myalgia, etc.), neuritis, neuralgia, radiculitis, burns, ulcers, bedsores. Prescribed alone or in combination with other drugs in the form of ointments, pastes, suppositories. Naftalan emulsion is also used for douching, compresses, tampons, baths.

Paraffin wax (ceresin) is a mixture of solid hydrocarbons obtained during the refining of petroleum and shale oil. White semi-translucent mass, slightly greasy to the touch. Melting point 50-57 ° C. Used as a base for ointments. Due to the high heat capacity and low thermal conductivity, paraffin is used for heat treatment for neuralgia, neuritis, etc. Ozokerite is used for the same purpose. Compresses impregnated with molten paraffin or paraffin cakes are prescribed as an antiseptic.

Ozokerite - a waxy mass of black color, a fossil substance of petroleum origin. Contains ceresin, paraffin, mineral oils, resins and other substances. It is used as an antiseptic as a means of high heat capacity and low thermal conductivity, for the treatment of heat in neuritis, neuralgia and other diseases. It is prescribed in the form of compresses (gauze pads soaked in ozokerite, temperature 45-50 ° C, covered with wax paper, oilcloth, cotton wool) and cakes (molten ozokerite, poured into a cuvette and cooled to 45-50 ° C). A compress or cake is applied for 40-60 minutes. The course of treatment consists of 15-20 procedures, which are carried out daily or every other day. Heated ozokerite in a water bath. Sterilized by heating at 100 ° C for 30-40 minutes.

Balm Shostakovsky (vanillin), polyvinyl butyl alcohol, is used for boils, carbuncles, trophic ulcers, purulent wounds, mastitis, burns, frostbites and inflammatory diseases. Promotes the cleansing of wounds, tissue regeneration and epithelialization. It is prescribed as an antiseptic externally for wetting napkins and direct application to the wound surface and in the form of 20% solutions in oil, as well as ointments. Inside appoint for gastric ulcer, gastritis, colitis. It has an enveloping, anti-inflammatory and bacteriostatic effect (gelatin capsules). They are taken once a day, 5-6 hours after a meal (it is recommended to take them at 11-12 am after a light dinner at 6 pm). On the first day, take 3 capsules, then 5 capsules, the course of treatment is 16-18 days.

Tsigerol, a clear oily liquid, is used as an antiseptic for the treatment of ulcers, granulating wounds, burns, etc. A sterile bandage (gauze) is moistened, which is applied to the wound surface and covered with compress paper. For large wound surfaces and abundant discharge, compress paper is not applied. The dressing is done in 1-2 days, for burns in 4-5 days.

Autologous ointment - composition: engine oil or autol 85 parts, stearin 12 parts, zinc oxide 3 parts. It is used as an antiseptic in the treatment of ulcers, wounds, burns and as a basis for other ointments.

Sulsen, contains about 55% selenium and 45% sulfur. It is used as an antiseptic in the treatment of seborrhea of \u200b\u200bthe scalp. Sulsen soap contains 2.5% sulsen, the same amount of sulsen paste mixed with a special foaming base. Apply sulsen soap or paste after washing your hair as usual. Then the damp hair is lathered with sulsen soap and rubbed thoroughly into the scalp. Use 2-3 g of soap for washing (one bar of soap for 8-10 procedures). The foam is left on the hair for 5-10 minutes, after which it is thoroughly washed off with warm water (no higher than 40 ° C) and the hair is wiped dry. A tube with sulsen paste is designed for 6-8 procedures, one teaspoon per dose. Sulsen preparations are used once a week (for oily seborrhea in the first 2 weeks, it can be used twice a week) for 1-1.5 months. In case of relapse, the course of treatment is repeated. Foam and rinsed water must not come into contact with the eyes. After the procedure, you should thoroughly wash your hands with warm water. Sulsen soap should be stored in a tight container, protected from light.

Antiseptics. Phytoncidal and other herbal antibacterial drugs

Phytoncides are called bactericidal, fungicidal substances contained in plants. They are especially abundant in juices and volatile fractions of onions, garlic, radishes, horseradish. Preparations made from them can also have an effect as an antiseptic on the body, enhance the motor, secretory function of the gastrointestinal tract, and stimulate cardiac activity.

Garlic tincture - is used mainly to suppress the processes of putrefaction and fermentation in the intestine, with intestinal atony and colitis, it is prescribed as an antiseptic also for hypertension and atherosclerosis. It is taken orally 10-20 drops (for adults) 2-3 times a day before meals.

Allilsat - alcohol (40%) extract from garlic bulbs. Assign 10-20 drops (in milk) 2-3 times a day as an antiseptic for adults. Garlic preparations are contraindicated in kidney disease, as they can cause irritation of the renal parenchyma.

Allilchen - alcohol extract from onions. Applied as an antiseptic inside 15-20 drops 3 times a day for several days with intestinal atony and diarrhea.

Urzalin - essential oil obtained from bear onion. It is used as an antiseptic in the treatment of purulent wounds, ulcers, bedsores, etc. 0.3% ointment on petroleum jelly is applied to gauze and applied to the damaged surface. The bandage is changed every 2-3 days.

Sodium sleep - sodium salt of usnic acid, isolated from lichens. It is an antibacterial agent. It is prescribed as an antiseptic in the form of a 1% aqueous-alcoholic or 0.5% oil solution (in castor oil), as well as in the form of a solution in glycerin, fir balsam. The solutions are liberally lubricated with gauze bandages, which are applied to the affected skin surface. When dusting wounds with powder, 0.1-0.2 g is consumed per wound about 16 sq cm in size.

Imanin - an antibacterial drug obtained from St. John's wort. It also has the ability to dry the wound surface and stimulate tissue regeneration. Applied as an antiseptic in the form of solutions, ointments, powders for the treatment of fresh and infected wounds, burns, ulcers, abscesses, nipple cracks, mastitis, boils, carbuncles. They are also used for acute laryngitis, sinusitis, rhinitis. Irrigate or wash the affected areas with a solution, then apply a wet bandage soaked in the same solution, changing it every day or every other day. 5-10% ointment is also used.

Tincture of calendula, alcoholic tincture of flowers and flower baskets of marigolds. It is used as an antiseptic for cuts, purulent wounds, burns, for rinsing with angina (1 teaspoon per glass of water). Inside, it is also taken as a choleretic agent (10-20 drops per dose).

Sophora Japanese tincture - used as an antiseptic for purulent inflammatory processes (wounds, burns, trophic ulcers) in the form of irrigation, washing, for wet dressings.

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In medical practice, the most relevant and common measure is the disinfection of premises, surgical instruments and directly individual parts of the human body. This implies the use of special tools. In this article, we will provide detailed information on what an antiseptic is.

Determination of measures using antimicrobial agents

Sterilization and disinfection methods play a fundamental role in the performance of various medical procedures. Knowledge of this constitutes the main sections in training in obtaining medical education. To understand what an antiseptic is, first you need to understand what antiseptics and asepsis are.

• Asepsis is a set of preventive measures that prevent the appearance of pathogenic microorganisms. Thanks to them, the patient receives reliable protection against the introduction of infectious pathogens into open wounds, as well as organs, tissues and other body cavities. Asepsis is mandatory for diagnosis, surgery and microbiological studies.
• Antiseptics is a complex suppression or destruction of organisms that pose a potential hazard to the patient's health, on the mucous membranes, damaged skin and cavities.

There are two sources of infection:

• Exogenous. External factors are the reason for the penetration of microbes. When pathogens enter from the outside, health workers resort to asepsis.
• Endogenous. The infection is in the human body. In this case, the main role is played by antiseptics.

Antiseptic

Since we are going to dwell on the means by which the treatment is carried out aimed at destroying bacteria, it will be appropriate to learn about the types of antiseptics.

Preventive. It consists in the implementation of the following actions:

• Treatment of fresh open wounds.
• Hygienic treatment of hands.
• Disinfection of the operating surface.
• Newborn precautions, such as umbilical wound care.
• Hand treatment of surgeons before surgery.
• Antiseptic of mucous membranes and skin infections.

Therapeutic. Antiseptics in medicine are used as directed. Each type of treatment has its own means. Here is a list of them:

• Biological (agents developed on the basis of antagonist bacteria and bacteriophages).
• Chemical antiseptics (bacteriostatic and bactericidal drugs).
• Mechanical antiseptic (use of solutions for primary treatment of wounds and after removal of infected tissue sites).
• Physical method (sorption, drainage, surgical treatment).
• Combined.

The type of antiseptic, which is mentioned last, is most often used in medical practice for the reason that one method of treatment is not enough. What is antiseptic in aggregate? Let's see how this happens using the example of treating a fresh wound.

Along with surgical techniques (chemical and mechanical), biological antiseptics are performed. To have a direct effect on the pathogen, tetanus serum or antibiotics are administered. After first aid, a physical antiseptic is immediately prescribed, implying physiotherapy procedures.

The role of germicidal agents

It is logical that in order to carry out antibacterial treatments, substances must be found that can defeat harmful bacteria. An antiseptic is an agent that prevents decomposition processes and destroys putrefactive microorganisms. The drugs developed for this purpose are classified according to their therapeutic effects:

• Bacteriostatic inhibits the growth of infectious agents.
• Germicidal destroy pathogens.
• Microbicides help break down viral particles.
• Antibacterial agents prevent the growth of bacteria.

The action of antimicrobial agents

Such substances penetrate the walls of bacterial cells, affect their cell membranes. This either inhibits the metabolic processes of microorganisms, or changes the permeability of their cell walls. Antiseptics are designed to inhibit or correct the growth of pathogenic microbes on living tissue sites. Thanks to them, the risk of infection and infection in humans and animals is reduced.

When an antimicrobial drug is prescribed, the pathogen is sampled from the patient and its sensitivity to the agent is checked. When choosing a topical antiseptic, the natural reaction of microbes at the site of application of the antibacterial liquid is recognized.

Antiseptics belong to the chemical group

Inorganic substances include alkalis, acids, peroxides. Separate elements are also used here: chlorine, silver, copper, iodine, zinc, bromine, mercury.

The organic group of synthetic substances includes derivatives of phenols and alcohols, quinolines, alkalis, aldegins, acids, nitrofurans and dyes.

Bioorganic antiseptics are products obtained from natural objects. Lichens, mushrooms and some plants can serve as biological raw materials.

Petroleum products, essential oils, tar and natural salts have also proven to be effective antiseptics.

All of the above chemical and biological substances are drugs and can be used at home.

Chemicals popular in medicine

• Phenol is the most common agent used to treat the hands of surgeons before surgery. It is part of other antibacterial drugs. The remedy is capable of defeating viruses and is prescribed for rinsing the mouth and throat. Phenol in powder form is used to treat navels in babies. In addition, it has an analgesic effect.
• Metal-containing compounds. A distinctive feature of these substances is their selective and specific action. They have a toxic effect on bacteria, and sparing on the human body. Because of these properties, they are used to treat sensitive organs. Mercury oxycyanide serves as a disinfectant. Optical instruments are treated with its solution. Eyes and mucous membranes are washed with silver nitrate.
• Haloids. Alcohol tincture of iodine is used as an antiseptic for the skin before surgery and venipuncture. Iodopyrone and iodonate are also widely used. Chloramine is an effective wound antiseptic because it contains active chlorine. A solution of sodium hypochlorite is irrigated and washed out contaminated open foci.
• Alkalis. From this group, ammonia solution (10%), sodium borate and ammonia are used for external treatment.
• Oxidizing agents. Purulent wounds are washed with hydrogen peroxide during dressing, and they also make lotions and rinses. The solution does not penetrate the tissues, it is used for decomposing cancerous tumors and bleeding of the mucous membranes.
• Dyes. Brilliant green has a pronounced antimicrobial effect. In medicine, an antiseptic is used to combat Pseudomonas aeruginosa and staphylococcus. "Zelenka" cleans well purulent skin lesions, abrasions, mucous membranes of the mouth, superficial wounds.
• Aldehyde compounds. An aqueous solution of formalin (40%) is used for disinfection of medical instruments, gloves, drains. Weak solution (4%), treat items for patient care. Dry formaldehyde powder is used to sterilize optical instruments. It is able to destroy bacteria and their spores within 5 hours.
• Acids. Boric acid solution prevents the growth and multiplication of many types of bacteria. It is used to treat ulcers, wounds, and mouth rinses.

The best remedy

During the discussion, we found out that doctors and their patients have many drugs at their disposal, each of which has a specific effect on bacteria. It is not possible to say that any of them is the most effective. We will try to highlight several criteria by which the best antiseptic is determined, according to its qualities. Firstly, a worthy remedy has either a good bactericidal effect, aimed at the death of microorganisms, or bacteriostatic, which helps to stop their reproduction. Secondly, it must be environmentally friendly and not have side effects on the human body. Thirdly, a drug is considered to be of high quality if it has a wide range of positive therapeutic effects. It is also necessary to consider whether the antiseptic will dissolve in lipids. The antimicrobial activity of the drug should not decrease during the period of body resistance, for example, in the presence of physiological and pathological substrates.

Important factors when choosing a product are the price and guarantee for the safety of its antibacterial properties.

Drugs

Spray products are considered very convenient to use. Antiseptics of this type do not create unnecessary difficulties when applying them. Some drugs are available commercially in large containers that allow the use of a spray bottle. The most common medicines include the following: "Himetic", "Panthenol", "Eco Breeze", "Octenisept", "BioLong", "Desisprey", "Combi Liquid", "Medonica".

Antiseptics in the form of an ointment are represented by the following drugs: "Geksikon", "Rescuer", "Betadin", "Levomikol". And also ointments: salicylic-zinc, boric, tetracycline and ichthyol.

It is important to know that many external antiseptic agents contain antibiotics that can provoke allergies. This must be taken into account when choosing a drug.

Natural antiseptics

Many medicinal herbs have a disinfecting effect. The string, tangerine oil, aloe vera, knotweed, lime, thyme are distinguished by good bactericidal properties. They are used in traditional medicine, as well as in the development of pharmaceuticals.

• Pharmacy tinctures: calendula, chamomile, eucalyptus leaves.
• Oils: juniper, incense, eucalyptus, lime and tea tree.

Buckthorn broth helps in the treatment of boils and eczema. Flax seeds are used for sores in the mouth.

Other applications

It was found that in recent years, bacteria have adapted to traditional methods of disinfection, and their reproduction has significantly accelerated. To prevent infection with fungal and viral infections, high-quality chemicals are used in hairdressing salons. Below is a brief description of some of them.

Antiseptic spray "Bacillon AF" is active against standard viruses. Used for express processing of surfaces and tools. This product should be used with caution, as it dries out the skin and causes flaking. Composition: ethanol (4.7%), propanol-1 (45%), glutoronic aldehyde (45%), propanol-2 (25%).

"Aerodezin". Alcohol-based spray intended for fast processing. After irrigation of objects, the agent is left on the surface for about 30 seconds. With prolonged use, a gray coating appears on the instruments. Composition: didecyldimethylammonium chloride (0.25%), protanol-1 (32.5), ethanol (18%). According to the instructions, the antiseptics mentioned above are not used to process medical instruments.

The latest innovation is sprayable hand treatments. They can be used in all public places and outdoors. They usually come in dispenser bottles that are easy to carry.

The widespread use of antiseptics is also observed in construction. They protect wooden structures from the appearance of blue, cracks, insects, and serve as the main layer for painting. Antiseptics penetrate the wood and form a film on the surface that protects against future damage.