Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-13T00:45:42.788Z Has data issue: false hasContentIssue false

Antimicrobial Efficacy of 3 Oral Antiseptics Containing Octenidine, Polyhexamethylene Biguanide, or Citroxx: Can Chlorhexidine Be Replaced?

Published online by Cambridge University Press:  02 January 2015

Nadine Rohrer
Affiliation:
School of Dentistry, University of Basel, Basel, Switzerland
Andreas F. Widmer*
Affiliation:
Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
Tuomas Waltimo
Affiliation:
School of Dentistry, University of Basel, Basel, Switzerland
Eva M. Kulik
Affiliation:
School of Dentistry, University of Basel, Basel, Switzerland
Roland Weiger
Affiliation:
School of Dentistry, University of Basel, Basel, Switzerland
Elisabeth Filipuzzi-Jenny
Affiliation:
School of Dentistry, University of Basel, Basel, Switzerland
Clemens Walter
Affiliation:
School of Dentistry, University of Basel, Basel, Switzerland
*
Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, Basel CH-4056, Switzerland (awidmer@uhbs.ch)

Extract

Background.

Use of oral antiseptics decreases the bacterial load in the oral cavity.

Objective.

To compare the antimicrobial activity of 3 novel oral antiseptics with that of Chlorhexidine, which is considered the “gold standard” of oral hygiene.

Design.

Comparative in vitro study.

Methods.

Four common oral microorganisms (Streptococcus sanguinis, Streptococcus mutans, Candida albicans, and Fusobacterium nucleatum) were tested under standard conditions and at different concentrations, by use of a broth dilution assay and an agar diffusion assay and by calculating the log10 reduction factor (RF). The antimicrobial activity of each antiseptic was assessed by counting the difference in bacterial densities (ie, the log10 number of colony-forming units of bacteria) before and after the disinfection process.

Results.

The oral antiseptics containing octenidine (with an RF in the range of 7.1–8.24 CFU/mL) and polyhexamethylene biguanide (with an RF in the range of 7.1–8.24 CFU/mL) demonstrated antimicrobial activity comparable to that of Chlorhexidine (with an RF in the range of 1.03–8.24 CFU/mL), whereas the mouth rinse containing Citroxx (Citroxx Biosciences; with an RF in the range of 0.22–1.36 CFU/mL) showed significantly weaker antimicrobial efficacy. Overall, octenidine and polyhexamethylene biguanide were more active at lower concentrations.

Conclusion.

Oral antiseptics containing the antimicrobial agent octenidine or polyhexamethylene biguanide may be considered as potent alternatives to chlorhexidine-based preparations.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Diefenderfer, KE, Ahlf, RL, Simecek, JW, Levine, ME. Periodontal health status in a cohort of young US Navy personnel. J Public Health Dent 2007;67:4954.Google Scholar
2.Dore, P, Robert, R, Grollier, G, et al. Incidence of anaerobes in ventilator-associated pneumonia with use of a protected specimen brush. Am J Respir Crit Care Med 1996;153:12921298.Google Scholar
3.Verma, P. Laboratory diagnosis of anaerobic pleuropulmonary infections. Semiti Respir Infect 2000;15:114118.Google Scholar
4.Chan, EY, Ruest, A, Meade, MO, Cook, DJ. Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis. BMJ 2007;334:889.Google Scholar
5.de Smet, AM, Kluytmans, JA, Cooper, BS, et al. Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med 2009;360: 2031.Google Scholar
6.Davies, GE, Francis, J, Martin, AR, Rose, FL, Swain, G. 1:6-Di-4'-chloro-phenyldiguanidohexane (hibitane); laboratory investigation of a new antibacterial agent of high potency. Br J Pharmacol Chemother 1954;9:192196.Google Scholar
7.Green, K, Livingston, V, Bowman, K, Hull, DS. Chlorhexidine effects on corneal epithelium and endothelium. Arch Ophthalmol 1980;98:12731278.Google Scholar
8.Aursnes, J. Vestibular damage from Chlorhexidine in guinea pigs. Acta Otolaryngol 1981;92:89100.CrossRefGoogle ScholarPubMed
9.Henschen, A, Olson, L. Chlorhexidine-induced degeneration of adrenergic nerves. Acta Neuropathol 1984;63:1823.CrossRefGoogle ScholarPubMed
10.Stingeni, L, Lapomarda, V, Lisi, P. Occupational hand dermatitis in hospital environments. Contact Dermatitis 1995;33:172176.Google Scholar
11.Kampf, G. Effect of Chlorhexidine probably overestimated because of lack of neutralization after sampling. Infect Control Hosp Epidemiol 2009;30: 811812; author reply 812-813.CrossRefGoogle ScholarPubMed
12.Dettenkofer, M, Wilson, C, Gratwohl, A, et al. Skin disinfection with octenidine dihydrochloride for central venous catheter site care: a double-blind, randomized, controlled trial. Clin Microbiol Infect 2010;16(6): 600606.Google Scholar
13.Rosin, M, Welk, A, Bernhardt, O, et al. Effect of a polyhexamethylene biguanide mouthrinse on bacterial counts and plaque. J Clin Periodontal 2001;28:11211126.Google Scholar
14. Pressdispensary. UK company launches health essential for travelling abroad. Citroxx natural biocide helps beat bird flu and other infections. http://www.pressdispensary.co.uk/releases/c99835.php. Accessed October 26, 2009.Google Scholar
15.Mueller, SW, Krebsbach, LE. Impact of an antimicrobial-impregnated gauze dressing on surgical site infections including methicillin-resistant Staphylococcus aureus infections. Am J Infect Control 2008;36:651655.CrossRefGoogle ScholarPubMed
16.Tietz, A, Frei, R, Dangel, M, et al. Octenidine hydrochloride for the care of central venous catheter insertion sites in severely immunocompromised patients. Infect Control Hosp Epidemiol 2005;26:703707.CrossRefGoogle ScholarPubMed
17.Pitten, FA, Doering, S, Kramer, A, Rosin, M. In vitro assay for the screening of the plaque-reducing activity of antimicrobial agents. Arzneimittelforschung 2003;53:182187.Google Scholar
18.Pitten, FA, Werner, HP, Kramer, A. A standardized test to assess the impact of different organic challenges on the antimicrobial activity of antiseptics. / Hosp Infect 2003;55:108115.Google Scholar
19.Walter, C, Jawor, P, Bernimoulin, JP, Hägewald, S. Moderate effect of enamel matrix derivative (Emdogain Gel) on Porphyromonas gingivalis growth in vitro. Arch Oral Biol 2006;51:171176.Google Scholar
20.Razor, CE, Mitchell, PM, Lee, AM, et al. Diversity of bacterial populations on the tongue dorsa of patients with halitosis and healthy patients. J Clin Microbiol 2003;41:558563.Google Scholar
21.Estes, RJ, Meduri, GU. The pathogenesis of ventilator-associated pneumonia: I. mechanisms of bacterial transcolonization and airway inoculation. Intensive Care Med 1995;21:365383.Google Scholar
22.Hamada, S, Slade, HD. Biology, immunology, and cariogenicity of Streptococcus mutans. Microbiol Rev 1980;44:331384.CrossRefGoogle ScholarPubMed
23.Socransky, SS, Haffajee, AD, Cugini, MA, Smith, C, Kent, RL Jr. Microbial complexes in subgingival plaque. J Clin Periodontal 1998;25:134144.Google Scholar
24.Teughels, W, Kinder Haake, S, Sliepen, I, et al. Bacteria interfere with A. actinomycetemcomitans colonization. J Dent Res 2007;86:611617.Google Scholar
25.Van Hoogmoed, CG, Geertsema-Doornbusch, GI, Teughels, W, Quirynen, M, Busscher, HJ, Van der Mei, HC. Reduction of periodontal pathogens adhesion by antagonistic strains. Oral Microbiol Immunol 2008;23:4348.Google Scholar
26.Gmür, R, Munson, MA, Wade, WG. Genotypic and phenotypic characterization of fusobacteria from Chinese and European patients with inflammatory periodontal diseases. Syst Appi Microbiol 2006;29:120130.CrossRefGoogle ScholarPubMed
27.Brook, I. Fusobacterial infections in children. J Infect 1994;28:155165.Google Scholar
28.Budtz-Jorgensen, E. Hibitane in the treatment of oral candidiasis. J Clin Periodontal 1977;4:117128.Google Scholar
29.Cannon, RD, Chaffin, WL. Oral colonization by Candida albicans. Crit Rev Oral Biol Med 1999;10:359383.Google Scholar
30.Urzua, B, Hermosilla, G, Gamonal, J, et al. Yeast diversity in the oral microbiota of subjects with periodontitis: Candida albicans and Candida dubliniensis colonize the periodontal pockets. Med Mycol 2008;46:783793.Google Scholar
31.Decker, EM, Weiger, R, von Ohle, C, Wiech, I, Brecx, M. Susceptibility of planktonic versus attached Streptococcus sanguinis cells to Chlorhexidine. Clin Oral Investig 2003;7:98102.CrossRefGoogle ScholarPubMed
32.Kocak, MM, Ozcan, S, Kocak, S, Topuz, O, Erten, H. Comparison of the efficacy of three different mouthrinse solutions in decreasing the level of Streptococcus mutans in saliva. Eur J Dent 2009;3:5761.Google Scholar
33.Beiswanger, BB, Mallatt, ME, Mau, MS, Jackson, RD, Hennon, DK. The clinical effects of a mouthrinse containing 0.1% octenidine. J Dent Res 1990;69:454457.CrossRefGoogle ScholarPubMed
34.Patters, MR, Anerud, K, Trammel, CL, Kornman, KS, Nalbandian, J, Robertson, PB. Inhibition of plaque formation in humans by octenidine mouthrinse. J Periodontal Res 1983;18:212219.Google Scholar
35.Rosin, M, Welk, A, Kocher, T, Majic-Todt, A, Kramer, A, Pitten, FA. The effect of a polyhexamethylene biguanide mouthrinse compared to an essential oil rinse and a Chlorhexidine rinse on bacterial counts and 4-day plaque regrowth. J Clin Periodontal 2002;29:392399.CrossRefGoogle Scholar
36.Welk, A, Splieth, CH, Schmidt-Martens, G, et al. The effect of a polyhexamethylene biguanide mouthrinse compared with a triclosan rinse and a Chlorhexidine rinse on bacterial counts and 4-day plaque re-growth. J Clin Periodontal 2005;32:499505.Google Scholar