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[Antimicrobially effective compounded medications. Clinical value and critical comments].
1Pharmazeutisches Laboratorium des Neuen Rezeptur Formulariums, Eschborn.
Summary
Traditional triphenyl-methane dyes in dermatology require caution due to uncertain risks and variable efficacy. Safer topical antimicrobials like chlorhexidine and silver compounds are recommended for compounded medications.
Area of Science:
- Dermatology
- Pharmacology
- Antimicrobial agents
Context:
- Triphenyl-methane dyes have been traditionally used in topical dermatological treatments.
- Concerns exist regarding their pharmacological-toxicological risk-benefit ratio and raw substance quality.
- Antimicrobial efficacy can be insufficient, with potential cytotoxic effects and impaired wound healing.
Purpose:
- To reevaluate the use of traditional topical antimicrobial dyes in dermatology.
- To provide practical recommendations for compounded topical antimicrobial medications.
- To assess the suitability of various antimicrobial agents for dermatological use.
Summary:
- Triphenyl-methane dyes, including Chinolinolsulfat (Chinosol), Clioquinol, ethracidinlactate-monohydrate (Rivanol), and phenylmercuri-borate (Mercuchrom), present significant risks.
- Rivanol and Mercuchrom should be avoided due to negative benefit-risk profiles.
- Chlorhexidine salts, polihexanide, triclosan, polyvidone iodide, and silver compounds are recommended topical antimicrobials.
- The Neues Rezeptur Formularium (NRF) lists standardized formulations for these recommended agents.
Impact:
- Discourages the use of certain traditional dyes due to safety and efficacy concerns.
- Promotes the adoption of safer and more effective topical antimicrobial agents in dermatological practice.
- Guides the formulation of compounded medications for topical antimicrobial therapy.