Biocides: health care applications
Biocides are non-antibiotic chemical agents used as disinfectants, antiseptics or preservatives. They kill micro-organisms or inhibit their growth. Disinfectants are agents that are applied to inanimate objects, whereas antiseptics are agents that are applied to living tissue, typically skin or mucous membranes.
The 20th century has been the golden age of biocides, with the discovery, manufacture and commercialisation of many agents. Biocides have become routinely used in domestic products, such as washing powder and washing-up liquid, various fabrics (eg, bed linen), plastics (eg, chopping boards) and even toys. This is a result of increased public awareness of hygiene and greater commercial and marketing pressures. However, with the extensive use of these agents, the following questions may be asked:
- Are biocides being used appropriately?
- What are the risks of using so many biocide-containing products?
Applications in health care
One of the main applications of biocides is to preserve pharmaceutical and cosmetic products to prevent or limit microbial contamination that can occur under normal conditions of storage and use. Preservatives include chlorhexidine, benzalkonium chloride, benzyl alcohol, chlorocresol, parabens and isothiazolinones (used in cosmetics), to name but a few.
Biocides are also used for their antiseptic properties in a number of preparations. These include products used to clean wounds, products for acne, mouthwashes, throat lozenges and sprays, and wart treatments. Panel 1 (p640) lists some biocides used as antiseptics and disinfectants. A number of natural oils are also marketed for their antiseptic properties (eg, tea tree oil is used for various skin disorders because of its bactericidal and fungicidal properties).
Biocides are applied as front-line antimicrobial agents to prevent and control infections. The reduction of hospital-acquired infections (HAIs), such as those caused by methicillin-resistant Staphylococcus aureus or vancomycin-resistant enterococci, is a key government priority — reduced mortality and morbidity will decrease the overall burden on health services — and the application of biocides is an integral part of hospital disinfection policies. For example, the introduction of alcohol-based hand rubs and increased compliance with hand washing rules has been linked to a decrease in HAIs. It is now increasingly common for hospital staff to carry small bottles of alcohol-based hand rubs, clipped onto their clothes.
Another application of biocides in health care includes the “sterilisation” (the term “high-level disinfection” is preferred) of heat-labile medical equipment. For example, formulations containing glutaraldehyde, ortho-phthalaldehyde, hydrogen peroxide or peracetic acid are used to sterilise endoscopes.
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Citation: The Pharmaceutical Journal URI: 10997344
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