Antiseptikum

An antiseptic (antiseptikum) is an agent applied to living tissue to reduce the risk of infection by inhibiting or destroying microorganisms. It is distinct from a disinfectant, which is intended for inanimate surfaces. Antiseptics are designed to be safe for use on skin or mucous membranes, though they may still cause irritation or allergic reactions in some people.

Historically, antisepsis emerged in the 19th century with the work of Joseph Lister, who popularized phenol (carbolic acid) to reduce surgical infections. Since then, a variety of chemical classes have been developed and refined for topical use, including alcohols, iodine compounds, chlorhexidine, hydrogen peroxide, phenolics, and quaternary ammonium compounds. Each class has different spectra of activity, speed of action, and tissue tolerability.

Common antiseptics and their characteristics:

- Alcohols (ethanol, isopropanol): rapid bactericidal and fungicidal; evaporate quickly and are not suitable for deep wounds.

- Iodine and povidone-iodine: broad spectrum; can stain skin and mucous membranes; risk of iodine allergy.

- Chlorhexidine: broad, persistent activity on skin and mucosa; often used with alcohol; rare allergic reactions and tooth staining with some mouthwashes.

- Hydrogen peroxide: effective for cleansing and debridement at low concentrations; can be cytotoxic to healthy tissue at higher concentrations.

- Phenolics and other agents: historically important; usage declined due to toxicity concerns in some contexts.

Applications include preoperative skin preparation, wound cleansing, reduction of skin colonization, and medical hand hygiene (especially alcohol-based rubs). Safety considerations include potential irritation, allergic reactions, staining, and interference with wound healing if overused. Bacterial resistance to antiseptics can occur but is less common than antibiotic resistance; proper use and concentration selection mitigate risks.