[Application of octenidine-dihydrochloride antiseptic in otorhinolaryngology]

Octenidine-dihydrochloride, a skin antiseptic and surface disinfectant, is widely used in everyday practice; however, its use in otorhinolaryngological practice is not widespread. Octenidine-dihydrochloride is a pyridine derivate with a relatively broad antimicrobial spectrum, including Gram-positive and Gram-negative bacteria, enveloped viruses, and some fungi. Considering the contamination of the nose, oral cavity, and oropharynx, and the fact that the upper airway is the first line of defense against infections, upper-airway infections are common. Unfortunately, the resistance against antibiotics and antimycotics is increasing. Additionally, routine use of antiviral agents is unrecommended in upper airway viral infections. Therefore, using antiseptics can be beneficial, considering their aspecific effects, which are essential in preventing resistance. Regarding the otorhinolaryngological use of octenidine-dihydrochloride, previous studies concluded promising results, summarised in the present article. Since its antibacterial spectrum includes the most frequent bacteria for pharyngitis, octenidine-dihydrochloride-containing tablets might be beneficially used in pharyngitis. As a further advantage, octenidine-dihydrochloride and antibiotics show a synergistic effect. Investigating some special pharyngitis types, e.g., caused by Neisseria gonorrhoeae, also showed its effectiveness, in which case the resistance against azithromycin is increasing. In everyday medical practice, the surface of tracheostomy tubes, due to the biofilm formulation, is crucial in nosocomial infections. A previous study has investigated the effects of octenidine-dihydrochloride-coated tracheotomy tubes in decontaminating Pseudomonas aeruginosa and Staphylococcus aureus. Their results showed significant decontamination using the coated tracheostomy tubes. Another significant result was the reduction of methicillin-resistant S. aureus, which frequently colonises the nares and results in infections. It also showed effectivity against Candida albicans infections, commonly observed in mycotic pharyngitis, e.g., in the case of immunosuppression and overuse of antibiotics. Furthermore, C. albicans shows an increasing resistance against azoles. In conclusion, octenidine-dihydrochloride shows promising results in otorhinolaryngological infections; however, some results must be strengthened by further clinical studies. Orv Hetil. 2024; 165(15): 568–573.