We present brief description individual chemical classes of antiseptics and disinfectants.

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

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

Widely used in surgical practice for treating the surgical field, wounds, surgeon’s hands (70%), for alcohol compresses (40%), disinfection of instruments, suture material. 70% alcohol has an antiseptic effect, and 96%) also has a tanning effect.

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 sodium hypochlorite solution is used; a 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 minute, and spores within 15 minutes, while the toxic effect on tissue is insignificant. Alcohol tincture of iodine contains 2% iodine and 2.4% sodium iodide, and is the most effective antiseptic for treating the skin before surgery or venipuncture.

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

Iodonate And iodopyrone- organic iodine compounds. Use a 1% solution. Widely used as an antiseptic for the skin, especially during preoperative preparation of the surgical field.

Lugol's solution- contains iodine and potassium iodide; aqueous and alcohol solutions can be used. Combined action drug. It is used as a disinfectant to sterilize catgut, and as a chemotherapeutic agent to treat thyroid diseases.

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

Silver nitrate- a solution of inorganic silver salts has a pronounced bactericidal effect. A 0.1-2% solution is used to wash the conjunctiva and 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% ​​silver is used as a local antiseptic for the treatment of mucous membranes. They have an astringent and anti-inflammatory effect. 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, included in many powders and pastes. Has an anti-inflammatory effect, prevents the development of macerations.

Copper sulfate - has pronounced antimicrobial properties.

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

Lysol- a strong disinfectant. A 2% solution is used to disinfect care items, premises, and soak contaminated instruments. Currently practically not used.

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

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

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

Methylene blue - antiseptic against E. coli, pyogenic microbes. A 1-3% alcohol (or aqueous) solution is used to treat superficial wounds, abrasions, oral mucosa, skin, a 0.02% aqueous solution is used to wash wounds.

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

Salicylic acid - antiseptic. Used as a fungicidal agent for skin treatment. Has a keratolytic effect. It is used in the form of crystals (for tissue lysis), and is part of powders and ointments.

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

9.Oxidizing agents.Hydrogen peroxide solution - contains 27.5-31% hydrogen peroxide, the antimicrobial effect is due to its oxidizing properties. 3% the solution is the main preparation for washing purulent wounds during dressings, rinsing, lotions; it does not penetrate into tissues. It is used for bleeding from mucous membranes and disintegrating cancerous tumors, etc. It is part of pervomura and is an effective disinfectant ( 6% solution).

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

10. Detergents (surface-active compounds).Chlorhexidine bigluconate- an antiseptic that acts on gram-positive microbes and E. coli. A 0.5% alcohol solution is used to treat the surgeon’s hands and the surgical field. A 0.1-0.2% aqueous solution is one of the main preparations for washing wounds and mucous membranes and treating purulent wounds. Included in solutions for treating hands and the surgical field (Plivasept, AHD-special). Antiseptic soap with the addition of chlorhexidine is used to treat the surgeon's hands and the surgical field. Systematic use of chlorhexidine-containing soap leads to the accumulation of this substance on the skin and to the accumulation of antimicrobial action.

Zerigel- antiseptic for external use. Used for treatment (film-forming antiseptic) of hands and the surgical field.

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

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

Lifusol- contains furatsilin, linetol, resins, acetone (aerosol). Antiseptic for external use. Applied in the form of a film. Used for protection postoperative wounds and drainage holes from exogenous infection and for the treatment of 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. 8-hydroxyquinoline derivatives. Nitroxoline (5-NOK) - chemotherapeutic agent, "uroantiseptic". Used to treat urinary tract infections.

Enteroseptol, intestopan- chemotherapeutic agents used for intestinal infections.

13. Quinoxaline derivatives. Dioxidine- antiseptic for external use. A 0.1-1% aqueous solution is used to wash purulent wounds and mucous membranes, especially when antibiotics and other antiseptics are ineffective. For sepsis and severe infections, it can also be administered intravenously.

14. Nitroimidazole derivatives.Metronidazole (metragyl, flagyl, trichopolum) - chemotherapy agent wide range actions. Effective against protozoa, bacteroides and a number of anaerobes.

15. Tars, resins. Birch tar- a 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, liniments, is part of Vishnevsky's balsamic ointment (tar - 3 parts, xeroform - 3 parts, castor oil - 100 parts), used for the treatment of wounds, ulcers, bedsores, burns, frostbite. At local application 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 bacterial DNA synthesis by inhibiting the activity of microbial cell enzymes.

Fluoroquinolones (ciprofloxacin, ofloxacin, norfloxacin etc.) - active against gram-positive microbes, highly active against enterobacteria, mycobacterium tuberculosis. Mainly used for intestinal infections, abdominal cavity and pelvis, skin and soft tissues, sepsis.

17. Sulfonamides (sulfadiazine, sulfadimezine, sulfadimethoxine, sulfamonomethoxine, sulfamethoxazole, sulfalene). They disrupt the synthesis of folic acid by microbial cells and have a bacteriostatic effect on gram-positive and gram-negative bacteria, chlamydia, and toxoplasma. Combination preparations of sulfonamides with trimethoprim (Bactrim, Biseptol, Septrin, Sulfatone) are widely used in clinical practice for the treatment of bacterial infections of various localizations.

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

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

19. Antiseptics of plant origin. Phytoncides, chlorophyllipt, ectericide, balise, calendula - are mainly used as external antiseptics for washing superficial wounds, mucous membranes, and treating the skin. They have an anti-inflammatory effect.

Bacteriophages(bacterium + Greek phagos - devouring, synonym: phage, bacterial virus) - a virus that can infect a microbial cell, reproduce in it, forming numerous offspring and cause lysis of the bacterial cell. Antistaphylococcal, antistreptococcal and anti-coli bacteriophages are used mainly for washing and treating purulent wounds and cavities after identifying 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 serum proteins, containing in concentrated form antibodies against the measles virus, influenza, polio, anti-tetanus γ-globulin, as well as increased concentrations of antibodies against certain infectious agents or toxins released by them.

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

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

Biological antiseptics also include methods for increasing nonspecific and specific resistance of the body.

Nonspecific resistance and nonspecific 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 spleen xenoperfusate, perfusion through whole or fragmented spleen (pig), while relying 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, enhance the bactericidal activity of the blood), interferons, interleukins, roncoleukin, roferon, etc. (have a pronounced activating targeted effect on the immune system).

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

Main groups of antibiotics:

1. B-Lactam antibiotics:

1.1. Natural penicillins;

Semi-synthetic penicillins:

Penicillinase-resistant penicillins;

Aminopenicillins;

Carboxypenicillins;

Ureidopenicillins;

B-lactamase inhibitors;

1.2. Cephalosporins:

1st generation;

II generation;

III generation;

IV generation.

2. Antibiotics of other groups:

Carbapenems;

Aminoglycosides;

Tetracyclines;

Macrolides;

Lincosamides;

Glycopeptides;

Chloramphenicol;

Rifampicin;

Polymyxins.

Penicillins - all drugs in 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 of which the structure of the microbial cell wall is disrupted.

Natural penicillins. These include:

Benzylpenicillin (penicillin C);

Procainepenicillin (procaine salt of penicillin O);

Benzathine penicillin (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 have little activity against enterococci. Most strains of staphylococci (85-95%) produce B-lactamases and are resistant to the action of natural penicillins.

Penicillinase-resistant penicillins:

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 infections.

Aminopenicillins:

Ampicillin;

Amoxicillin;

Bacampicillin;

Pivampicillin.

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

Aptypseudomonal penicillins:

Carboxypenicillins (carbenicillin, ticarcillin);

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

Preparations containing penicillins and B-lactamase inhibitors:

Ampicillin and sulbactam - unasin;

Amoxicillin and clavulanic acid - amoxiclav, augmentin;

Ticarcillin and clavulanic acid - timentin;

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, E. coli), bind enzymes and protect the broad-spectrum penicillins contained in them from the action of B-lactamases. As a result, microorganisms that are resistant to them become sensitive to the combination of these drugs.

Cephalosporins I, II, III and IV generations. Ranked first among antibacterial agents by 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 incidence 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, cephalosporins of the first, second and third generations are most often used. IN recent years two drugs appeared, which, based on their antimicrobial properties, were classified as fourth generation cephalosporins.

First generation cephalosporins - cephaloridine, cephalothin, cefapirin, cefradine, cefazolin, cephalexin.

II generation cephalosporins - cefamandole, cefuroxime, cefoxitin, cefmetazole, cefotenan. They have a wider spectrum of action than first generation drugs.

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

Cephodisim - the only cephalosporin antibiotic with an immunostimulating effect.

Widely used to treat hospital infections.

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

Carbapenems. Carbapenems (imipenem, meropenem) and the combined carbapenem tienam (imipenem + sodium cilastatin) are characterized by the widest spectrum of antibacterial activity. They are used to treat severe infections, mainly hospital-acquired, especially when the causative agent of the disease is unknown. A wide spectrum and high bactericidal activity allow the use of 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 generation II (gentamicin) and III (sisomycin, amikacin, tobramycin, netilmicin) aminoglycosides are used.

Tetracyclines. They inhibit protein synthesis in microbial cells, have high activity against gram-positive and gram-negative microorganisms (aerobic and anaerobic), chlamydia, rickettsia, Vibrio cholerae, 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). Their spectrum of 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 lobar pneumonia, atypical pneumonia, streptococcal infections (tonsillitis, erysipelas, pharyngitis, scarlet fever).

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

Glycopeptides(vancomycin, teicoplanin). They disrupt bacterial cell wall synthesis and have a bactericidal effect. Active against streptococci, pneumococci, enterococci, corynebacteria.

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

Rifampicin. The mechanism of action is associated with the suppression of RNA synthesis in the microbial cell. 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.

Stepanova Olga Ivanovna
Assistant at the Department of Pharmacology, Faculty of Pharmacy, First Moscow State Medical University named after. THEM. Sechenova, Ph.D.
Belyatskaya Anastasia Vladimirovna
Associate Professor of the Department of Pharmaceutical Technology, Faculty of Pharmacy, First Moscow State Medical University named after. THEM. Sechenova, Ph.D.

Now it is difficult for anyone to imagine the “pre-antiseptic” period, when a huge number of patients died from even the most insignificant infections in modern terms. Also N.I. Pirogov noted that most of the wounded die not so much from the injuries themselves, but from “hospital infection.”

The modern (scientific) history of antiseptics is associated with the names of the Viennese obstetrician I. Semelweis and the English surgeon J. Lister. It should also be mentioned that simultaneously with them or even before them chemicals Many other doctors also used it to prevent suppuration and treat wounds. The Russian surgeon N.I. should rightfully be included among them. Pirogov, who in 1847-1856. widely used bleach solution, ethanol, silver nitrate.

So, let's remember what antiseptics are, and how they differ from similar terms - “disinfection” and “chemotherapeutic drugs”.

Antiseptics (Latin anti - against, septicus - rotting) - a system of measures aimed at destroying microorganisms in a wound, pathological focus of the body, organs and tissues, as well as in the patient’s body as a whole, using mechanical and physical methods of influence, active chemicals substances and biological factors. Unlike disinfection, which is a procedure involving the treatment of objects contaminated with microbes and environment in order to destroy them to such an extent that they cannot cause infection when using this item. As a rule, disinfection kills most microbes (including all pathogenic ones), however, spores and some resistant viruses may remain in a viable state.

There are a considerable number of classifications of antiseptic agents today. The most popular of them are presented below.

According to the mechanism of action, antiseptics are classified into mechanical, physical, biological and chemical.

Methods of mechanical action on microbes trapped in a wound include: removal of infected foreign bodies from the wound; excision of infected, damaged or non-viable tissue at the time of primary surgical treatment of the wound; opening of abscesses; use of the mechanical properties of hydrogen peroxide (foam formation) to wash the wound; vacuum treatment of wounds. Relatively new methods of antiseptic treatment of a wound, predominantly mechanical, include treating the wound with a pulsating stream of antiseptic, which easily removes necrotic sloughing tissue, pus and small foreign bodies. This method was proposed in the mid-80s. Academician M.I. Kuzin and prof. B.M. Kostyuchenko. Its widespread implementation is hampered mainly by the lack, unfortunately, of appropriate equipment.

Drainage of wounds, use of ultraviolet irradiation (UVR); low frequency ultrasound; laser scalpel; plasma scalpel; antibiotic electrophoresis; UHF refers to physical impact.

Use of antibiotics; immune drugs; extracorporeal detoxification on xenoorgans; the use of proteolytic enzymes is a biological effect on pathogens.

According to the method of application, antiseptics are distinguished - general and local. The latter, in turn, is divided into superficial and deep. With general antiseptics, a chemical or biological factor is introduced into the internal environment of the body (intravenously, intramuscularly, endolymphatically, etc.), affecting the body as a whole. This type of antiseptic is also called chemotherapy. Local antiseptic implies local action antiseptic factors. With superficial antiseptics, an effect is applied to the surface of the wound or to the integument of the body (treating the surface of the wound with a laser beam, washing the wound with an antiseptic solution, etc.). With deep antiseptics, factors act in tissues or cavities affected by the infectious process (introduction of antibiotics and chemical antiseptics into tissues and cavities of the body by puncture, electrophoresis, phonophoresis, etc.). The same measures are sometimes called local chemotherapy.

Antiseptics Most often they are produced in the following dosage forms: tablets, patches, films, powders, solutions, drops, sprays, etc.

Today, most antiseptics can be found in the assortment of almost any pharmacy.

Medicines used for sore throat

For sore throats, remedies from halogen groups, united under the trade name (TN) "Strepsils", produced in the form of lozenges (sometimes mistakenly called lollipops or lozenges) and dosed spray for topical use.

Strepsils(2,4-dichlorobenzyl alcohol + amylmetacresol + excipients); Strepsils with vitamin C(2,4-dichlorobenzyl alcohol + amylmetacresol + ascorbic acid (vitamin C) + excipients); Strepsils Plus(2,4-dichlorobenzyl alcohol + amylmetacresol + lidocaine hydrochloride + excipients); Strepsils with menthol and eucalyptus(2,4-dichlorobenzyl alcohol + amylmetacresol + levomenthol + eucalyptus oil + excipients); Strepsils Intensive(flurbiprofen + excipients) .

The drug combines really effective antimicrobial agents. The active substance amylmetacresol destroys the very shell of microbes, and the second substance - dichlorobenzyl alcohol - causes dehydration, i.e. dehydration of the microorganism.

Indications for use: treatment of infectious and inflammatory diseases of the oral cavity and pharynx (relieves pain and soothes irritation in the throat). Thus, there is a targeted effect on suppressing the vital activity of microbes. Side effects: rarely - allergic reactions.

Hexethidine ( Stopangin) - a pyrimidine derivative - an antiseptic for topical use in ENT practice, has broad-spectrum antimicrobial and antifungal activity, and an analgesic effect when applied to the mucous membrane; In addition, it has an enveloping effect. The antimicrobial effect is associated with the suppression of oxidative reactions of bacterial metabolism (thiamine antagonist). Release form: spray for topical use and solution for topical use (transparent, light red in color. Composition: hexethidine spray - a mixture of essential oils (anise, eucalyptus, orange flower essential oil, sassafras, peppermint; menthol, methyl salicylate). Hexetidine solution - a mixture of essential oils: anise, eucalyptus, sassafras, peppermint, clove oil; menthol, methyl salicylate. Indications for use: infectious and inflammatory diseases of the oral cavity and larynx (tonsillitis, tonsillitis, pharyngitis, stomatitis, aphthous ulcers of the oral cavity, glossitis). , periodontitis, bleeding gums), fungal diseases of the oral cavity and larynx, injuries of the oral cavity and larynx), oral hygiene to eliminate unpleasant odor from the mouth.

Contraindications: atrophic pharyngitis, childhood up to 6 years, first trimester of pregnancy, individual intolerance to the components of the drug. Important! Side effects: burning of the mucous membrane (quickly resolves spontaneously), allergic reactions, if the drug is accidentally swallowed, nausea may occur (passes spontaneously).

Hexethidine ( Hexoral) is available in aerosol form. Stopangin and Hexoral have a common active ingredient and quite a lot in common in their composition, so their scope of action is identical. But Hexoral, unlike Stopangin, can be used by pregnant women in the first trimester of pregnancy, and in other cases the decision remains with the doctor.

Chlorhexidine (chlorhexidine) is a versatile antiseptic, which today can be purchased not only in the form of a solution, but also in cream, gel, and patch. The drug kills germs, bacteria, some viruses, is effective against purulent processes. An additional advantage of chlorhexidine solution is its affordable price. The bacteriostatic effect of solutions is manifested in concentrations of up to 0.01%; the bactericidal effect is manifested at a concentration level above 0.01% (at a solution temperature of 22ºC and its effect on the affected area of ​​the skin for 1 minute or more); the fungicidal effect is manifested at a solution concentration of 0.05% (at a temperature of 22ºC and exposure of the solution to the affected area of ​​the skin for 10 minutes); the virucidal effect (suppressing lipophilic viruses) is manifested at a concentration level in the range of 0.01-1% (suppression of bacterial spores is possible only when using a warm solution). A 0.2% solution of the drug can be used to prevent sexually transmitted infections (in particular ureaplasmosis, chlamydia, trichomoniasis, syphilis, gonorrhea and genital herpes). Disinfectant treatment and sanitation with a solution should be carried out no later than 2 hours after the end of sexual intercourse. A 0.5% solution of the drug can be used to treat wounds, skin cracks, burns, open mucous membranes and infected abrasions in order to disinfect them. Indications for the use of chlorhexidine: disinfection of wounds on the skin and even mucous membranes; course treatment of fungal diseases; prevention of sexually transmitted diseases; course treatment of stomatitis, periodontitis and gingivitis.

If to treat a cut it is enough to apply a solution to the wound, then to solve the problem of the diseases mentioned above, the order and frequency of actions is established by the attending physician. When using Chlorhexidine, individual allergic reactions, dry skin, itching, and dermatitis are possible. The most common side effect is dermatitis. However, complaints about antiseptics are extremely rare in medical practice.

Chlorhexidine should be used with extreme caution by women during pregnancy and lactation, people with individual intolerance to the drug, as well as children under adolescence.

Allantoin + Povidone-iodine ( Yox) - an aerosol with an antiseptic and anti-inflammatory effect, available both in the form of a spray and a solution for topical use. Indications: infectious and inflammatory diseases of the oral cavity and pharynx (tonsillitis, tonsillitis, tonsillopharyngitis, glossitis, stomatitis). It is used for treating the oral cavity and pharynx during surgical interventions on the respiratory tract and oral cavity, as well as in postoperative period; for the treatment of infections of the mouth and throat that occur during chemotherapy, as well as for streptococcal sore throats as an additional remedy in antibiotic treatment. The mechanism of action is a direct effect on the proteins of microorganisms. Important! Possible side effects - iodism (increased iodine content in the body) and rarely - allergic reactions; Contraindicated in pregnancy and breastfeeding, children under 6 years of age, as well as in hyperthyroidism, heart failure and hypersensitivity to iodine.

Gramicidin C + Cetylpyridinium chloride ( Gramicidin NEO) - a combined drug for the treatment of infectious and inflammatory diseases of the throat and oral cavity, produced in the form of lozenges, belongs to the biological antiseptics microbial origin. The drug contains an antibiotic for topical use, gramicidin C, and an antiseptic, cetylpyridinium chloride. The mechanism of action is associated with an increase in the permeability of the cytoplasmic membrane of the microbial cell, which violates its stability and causes cell death. Gramicidin C has a pronounced antimicrobial effect against pathogens of infectious diseases of the oral cavity and pharynx. Side effects: allergic reactions due to individual sensitivity. Important! Contraindications: hypersensitivity to the components included in the drug; children under 4 years of age; pregnancy (first trimester).

Antiseptic Cetylpyridinium chloride is part of other combination drugs: Cetylpyridinium chloride + Benzocaine ( Septolete plus) is available in lozenges; Cetylpyridinium chloride + Lidocaine hydrocholide ( Kalgel), dental gel is produced, used for teething and Cetylpyridinium chloride + Lidocaine hydrocholide ( Theraflu LAR Menthol), lozenges.

Acetylaminonitropropoxybenzene ( Fallimint) is a nitroacetanilide derivative, available in the form of dragees; when absorbed, it creates a feeling of coolness in the mouth and larynx, has an antitussive, antiseptic, analgesic and weak local anesthetic effect. Does not have a drying effect on the mucous membranes, does not cause a feeling of numbness in the mouth. Indications: tonsillitis, pharyngitis, laryngitis, gingivitis, stomatitis, reflex cough, preparation for instrumental examinations of the oral cavity and pharynx, taking impressions and fitting dentures. Contraindications: hypersensitivity to the components of the drug, pregnancy, lactation, children under 5 years of age, sucrase or isomaltose deficiency, fructose intolerance, glucose-galactose malabsorption.

Medicines for inflammatory diseases of the oral mucosa and after dental interventions

Rotokan, produced in the form of a solution in orange glass bottles, refers to group of alcohols it consists of a hydroalcoholic extract from a mixture of medicinal plant materials - chamomile flowers, calendula flowers (marigold) and yarrow herb in a ratio of 2:1:1. Pharmacological action - anti-inflammatory. The drug enhances the processes of reparative regeneration, has hemostatic and antispasmodic properties, and has a positive effect on the trophism of the gastric mucosa. Rotocan is low-toxic and does not have allergenic, teratogenic or mutagenic properties. It is used for inflammatory diseases of the oral mucosa and periodontium of various etiologies, such as aphthous stomatitis, periodontitis, ulcerative necrotizing gingivostomatitis. Important! The use of the drug is contraindicated in patients with hypersensitivity to the plants contained in it; side effects are possible - allergic reactions.

Miramistin + Benzyldimethyl ammonium chloride monohydrate ( Miramistin) refers to the group of detergents, Available in the form of a solution for topical use 0.01%. Indications: treatment and prevention of infectious and inflammatory diseases of the oral cavity - stomatitis, gingivitis, periodontitis, periodontitis. Also applicable for hygienic treatment removable dentures. Side effects: in some cases, a slight burning sensation may occur at the site of application, which goes away on its own after 15-20 seconds and does not require discontinuation of the drug; allergic reactions. Contraindications: individual intolerance to drugs.

Benzalkonium chloride + peppermint leaves oil + thymol + eucalyptus rodentosa leaves oil + Levomenthol ( Septolete lozenges). It is a combination of an antiseptic from the group of quaternary ammonium compounds ( benzalkonium chloride) and active natural substances ( menthol, peppermint essential oil, eucalyptus essential oil, thymol). Benzalkonium chloride has a bactericidal effect on gram-positive and gram-negative bacteria, as well as a fungicidal effect against Candida albicans and some lipophilic viruses. Menthol and peppermint essential oil have a moderate analgesic and deodorizing effect. Lozenges relieve sore throat when swallowing, as well as a sore throat. Thymol has an antiseptic effect, which enhances the effectiveness of the drug. Essential oil eucalyptus reduces mucus secretion in the upper regions respiratory tract and makes breathing easier. The drug does not contain sugar, which allows it to be taken by patients diabetes mellitus. Indications: pharyngitis, laryngitis, tonsillitis, gingivitis, stomatitis. Important! There are contraindications: children under 4 years of age, deficiency of the enzyme lactase, isomaltase, galactosemia, hypersensitivity to the components of the drug. Side effects: allergic reactions, nausea, diarrhea.

Remedies used for burns

Dexpanthenol ( Bepanten plus cream, 5% in aluminum tubes) quickly turns into pantothenic acid in skin cells, which plays an important role in both the formation and healing of damaged skin. Quickly absorbed. When applied to the surface of a wound, it protects against infection, promoting healing. Easy to apply and wash off. The composition of Bepanten Plus cream is as follows: 1 g of cream contains 50 mg dexpanthenol, 5 mg chlorhexidine dihydrochloride. The composition includes additional substances: cetyl alcohol, DL-pantolactone, stearyl alcohol, liquid paraffin, white soft paraffin, lanolin, polyoxyl 40, stearate, water. Important! Hypersensitivity to the components of the drug is possible, and a side effect is an allergic reaction (urticaria, itching).

Products used for open wounds

Hydrogen peroxide (hydrogen peroxide solution,bottles of 40 and 25 ml) from the “oxidizing agents” group is suitable even for infants. For example, they are recommended to treat the umbilical wound of a newborn. The main advantage of hydrogen peroxide in comparison with brilliant green and iodine is that the solution can be applied to an open wound. At the same time, hydrogen peroxide does not “sting”. After treating the surface of a fresh wound with a solution of hydrogen peroxide, you can notice how the antiseptic foams. At this moment, a disinfection process occurs: atomic oxygen is released, which rids the wound of germs, pus and dead tissue. Antiseptic effect Hydrogen peroxide is not a sterilizing agent; its use causes only a temporary reduction in the number of microorganisms. Indications for use: for washing and rinsing for stomatitis, tonsillitis, and gynecological diseases. Small superficial wounds, small capillary bleeding from superficial wounds, nosebleeds.

Nitrofural ( Furacilin) is a derivative of nitrofuran. Indications for use: purulent wounds, bedsores, burns II-III degree. and many more etc. (see instructions for use).

Important! Side effects: in some cases, dermatitis occurs. Sometimes when taken orally, dyspeptic symptoms (loss of appetite, nausea, vomiting), dizziness, and allergic rashes are observed. Long-term use of drugs can cause neuritis. With long-term (months) topical use, graying of hair and skin depigmentation (leucoderma) are observed in areas exposed to the direct action of the drug. Contraindications: increased individual sensitivity to nitrofuran derivatives. Orally administered with caution in case of impaired renal function. Release forms: powder, tablets for oral administration (rarely); combined tablets for external use, 0.02% furatsilin solution (1:5000) for external use, 0.2% furatsilin ointment (1:500); Furacilin paste for hands and face against exposure to various irritating chemicals.

The low solubility of furatsilin in water (1:5000) limits the use of this well-known drug due to the inconvenience associated, first of all, with the preparation of the solution - long-term dissolution of factory-made tablets or powder in boiling water. Currently, on the basis of the departments of pharmacology and pharmaceutical technology of the pharmaceutical faculty of the State Budgetary Educational Institution of Higher Professional Education of the First Moscow State Medical University named after. THEM. Sechenov of the Russian Ministry of Health has developed a rapidly dissolving dosage form of Furacilin - effervescent tablets.

Antiseptics for local preventive use for every day

Antiseptic hand gel Sanitelle ( Sanitel) in single-use sachets is easy to use, destroys 99.9% of the most common bacteria, fungi and viruses within 15 seconds. The gel contains: ethyl alcohol 66.2%, deionized water, glycerin, propylene glycol, aloe vera extract, vitamin E, functional additives. Contraindications: individual intolerance to the drug.

All of the above antiseptics are dispensed without prescriptions and are freely available in pharmacies, however, if you have wounds or non-healing ulcers of unknown pathogenesis, you should definitely consult a doctor. Abuse medicines also has a number of dangers associated with them side effects And individual characteristics person.