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Published on: September 16, 2022
Clinical application of skin antisepsis using aqueous olanexidine: a scoping review
Yutaro Shinzato1, Eiryu Sakihara1, Yuki Kishihara1
1Department of Emergency and Critical Care Medicine Jichi Medical University Saitama Medical Center Saitama Japan.
Abstract:
Surgical site infections (SSIs) and catheter-related bloodstream infections (CRBSIs) caused by bacteria from surfaces poorly disinfected with chlorhexidine gluconate (CHG) and povidone-iodine (PVP-I) are increasing. Olanexidine gluconate (OLG) was developed in 2015 in Japan to prevent SSI and CRBSI caused by bacteria resistant to CHG and PVP-I. This scoping review aimed to identify the knowledge gap between what is known and what is not known about the disinfection efficacy of OLG. We searched MEDLINE through PubMed, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the International Clinical Trials Registry Platform search database, ClinicalTrials.gov, and the Web-based database of Japanese medical articles for works published to July 18, 2021. Manual reference searches were also carried out. A total of 131 studies were screened. Forty-seven studies were included in this review and classified into two major categories: studies on pharmacological effects and spectrum (n = 29) and studies on clinical and adverse effects (n = 18). Olanexidine gluconate showed bactericidal activity against methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, in addition to common Gram-positive and Gram-negative bacteria. In clinical settings, although there is limited evidence on SSI prevention, 1.5% OLG might be more effective than 10% PVP-I and 1% CHG in preventing SSI. However, the clinical usefulness of OLG is unclear due to the limited number of clinical studies. Also, clinical research is limited to studies targeting SSI prevention, and there are no clinical studies on CRBSI. Further clinical studies are needed on SSI and CRBSI prevention.
Insights
Olanexidine gluconate (OLG) shows promise in combating resistant bacteria, potentially outperforming chlorhexidine gluconate (CHG) and povidone-iodine (PVP-I) for surgical site infections (SSIs). However, more clinical research is needed to confirm its efficacy for SSIs and catheter-related bloodstream infections (CRBSIs).
Area of Science:
- Antimicrobial efficacy and infection prevention strategies.
- Pharmacology and clinical applications of novel disinfectants.
Background:
- Increasing rates of surgical site infections (SSIs) and catheter-related bloodstream infections (CRBSIs) due to bacterial resistance to traditional disinfectants like chlorhexidine gluconate (CHG) and povidone-iodine (PVP-I).
- Development of olanexidine gluconate (OLG) in Japan (2015) as a potential alternative for preventing SSIs and CRBSIs caused by resistant bacteria.
Purpose of the Study:
- To conduct a scoping review to identify the existing knowledge and knowledge gaps regarding the disinfection efficacy of OLG.
- To evaluate OLG's effectiveness against resistant bacterial strains and its clinical utility in preventing healthcare-associated infections.
Main Methods:
- Comprehensive literature search across multiple databases (PubMed, CINAHL, Cochrane, ClinicalTrials.gov, etc.) up to July 18, 2021.
- Inclusion of 47 studies categorized into pharmacological/spectral effects (29 studies) and clinical/adverse effects (18 studies).
- Manual reference searches were performed to supplement database findings.
Main Results:
- OLG demonstrated bactericidal activity against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and common Gram-positive and Gram-negative bacteria.
- Preliminary clinical evidence suggests 1.5% OLG may be more effective than 10% PVP-I and 1% CHG in SSI prevention, though data is limited.
- Significant limitations exist due to a scarcity of clinical studies, particularly concerning CRBSI prevention.
Conclusions:
- OLG exhibits broad-spectrum bactericidal activity, including against key resistant pathogens.
- While initial findings suggest potential superiority over existing agents for SSI prevention, the clinical usefulness of OLG remains uncertain due to limited evidence.
- Further rigorous clinical trials are essential to establish the efficacy and safety of OLG for both SSI and CRBSI prevention.
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