Activity of the Antiseptic Polyhexanide Against Gram-Negative Bacteria

Fabry, Werner; Kock, H. J.; Vahlensieck, W.

doi:10.1089/mdr.2013.0113

Cited by 22 publications

(6 citation statements)

References 12 publications

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“…So far, it remains unclear if this would also be a suitable option for Gram‐negative germs in clinical routine. In laboratory investigations, polihexanid proved to be non‐antagonistic and was not resisted when used against Gram‐negative bacteria and was evaluated as an adequate agent for the topical eradication of Gram‐negative germs by the authors . Furthermore, resistance and side effects are feared in the case of prophylactic use of antiseptics .…”

Section: Discussionmentioning

confidence: 99%

“…In laboratory investigations, polihexanid proved to be nonantagonistic and was not resisted when used against Gramnegative bacteria and was evaluated as an adequate agent for the topical eradication of Gram-negative germs by the authors. 25 Furthermore, resistance and side effects are feared in the case of prophylactic use of antiseptics. 26 Alternatively, there are wound dressings that allow the reduction of bacterial load of critically contaminated wounds through the use of silver or the potential to bind microorganisms.…”

Section: What Rates Of Resistance Are Present In Detected Germs?mentioning

confidence: 99%

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Impact of Gram‐negative bacteria on the treatment of venous leg ulcers

Engelberg

Dörler

Stücker

et al. 2018

International Wound Journal

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Gram-negative germs with and without multi-resistance are garnering more and more importance. The aim of this study was to investigate the frequency and rate of resistance against antibiotics and to clarify the impact of Gram-negative bacteria, especially with high rates of resistance, for the treatment of venous leg ulcers. This is a retrospective, monocentric, non-randomised open study. Included were all data within 1 year of bacterial swabs of venous leg ulcers. We performed summarization, pooling, and descriptive analysis for frequencies and crossover. We analysed 679 swabs of 285 patients with venous leg ulcers. The mean patient age was 69.78 years. There were 76.1% Gram-positive and 58.2% Gram-negative germs detected; 56.5% of the swabs showed multi-resistance. Gram-negative bacteria were associated with more pain. Exacerbation and relevant aggravation of wounds that led to stationary treatment occurred more frequently. With polihexanid treatment, we saw less Gram-negative flora. This study showed an immediate impact of Gram-negative germs on the patient's pain, the risk for aggravation, and the choice of treatment. Further studies for prophylaxis and treatment of Gram-negative germs in venous leg ulcer therapy are needed.

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Section: Discussionmentioning

confidence: 99%

Section: What Rates Of Resistance Are Present In Detected Germs?mentioning

confidence: 99%

Impact of Gram‐negative bacteria on the treatment of venous leg ulcers

Engelberg

Dörler

Stücker

et al. 2018

International Wound Journal

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“…Thus, PHMB (0.02%) is the preferred agent for the treatment of Acanthamoeba keratitis [85]. Efficacy against P. aeruginosa can still be observed in the presence of 4% albumin [86], 4.5% blood + 4.5% albumin [87], and wound exudates, while the expression of elastase is inhibited at the same time [88]. In a wound model on pigs, MRSA was significantly reduced after 72 h by PHMB in a wound treatment matrix based on collagen, while silver dressings were ineffective [89].…”

Section: Polihexanidementioning

confidence: 99%

Consensus on Wound Antisepsis: Update 2018

Krämer

Dissemond²,

Kim³

et al. 2017

Skin Pharmacol Physiol

217

193

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Wound antisepsis has undergone a renaissance due to the introduction of highly effective wound-compatible antimicrobial agents and the spread of multidrug-resistant organisms (MDROs). However, a strict indication must be set for the application of these agents. An infected or critically colonized wound must be treated antiseptically. In addition, systemic antibiotic therapy is required in case the infection spreads. If applied preventively, the Wounds-at-Risk Score allows an assessment of the risk for infection and thus appropriateness of the indication. The content of this updated consensus recommendation still largely consists of discussing properties of octenidine dihydrochloride (OCT), polihexanide, and iodophores. The evaluations of hypochlorite, taurolidine, and silver ions have been updated. For critically colonized and infected chronic wounds as well as for burns, polihexanide is classified as the active agent of choice. The combination 0.1% OCT/phenoxyethanol (PE) solution is suitable for acute, contaminated, and traumatic wounds, including MRSA-colonized wounds due to its deep action. For chronic wounds, preparations with 0.05% OCT are preferable. For bite, stab/puncture, and gunshot wounds, polyvinylpyrrolidone (PVP)-iodine is the first choice, while polihexanide and hypochlorite are superior to PVP-iodine for the treatment of contaminated acute and chronic wounds. For the decolonization of wounds colonized or infected with MDROs, the combination of OCT/PE is preferred. For peritoneal rinsing or rinsing of other cavities with a lack of drainage potential as well as the risk of central nervous system exposure, hypochlorite is the superior active agent. Silver-sulfadiazine is classified as dispensable, while dyes, organic mercury compounds, and hydrogen peroxide alone are classified as obsolete. As promising prospects, acetic acid, the combination of negative pressure wound therapy with the instillation of antiseptics (NPWTi), and cold atmospheric plasma are also subjects of this assessment.

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“…Accordingly, polyhexanide was shown to have potent antimicrobial activity against both Gram-positive and Gram-negative bacteria (8,12). In contrast to the situation with other antiseptics, reduced susceptibility to polyhexanide and its association with antibiotic resistance has not yet been detected (12)(13)(14)(15)(16). Another exceptional characteristic recently identified for polyhexanide is its intracellular bactericidal activity, recognized as an important property for potentially treating skin infections caused by intracellular bacteria (17).…”

mentioning

confidence: 99%