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Topical antimicrobial toxicity
Abstract:
Three topical antibiotics and four antiseptics (1% povidone-iodine, 0.25% acetic acid, 3% hydrogen peroxide, and 0.5% sodium hypochlorite) were directly applied to cultured human fibroblasts to quantitatively assess their cytotoxicity. The four antiseptics were found to be cytotoxic; all of the cytotoxic agents except hydrogen peroxide were subsequently found to adversely affect wound healing in an animal model. Comparison of bactericidal and cytotoxic effects of serial dilutions of these four topical agents indicated the cellular toxicity of hydrogen peroxide and acetic acid exceeded their bactericidal potency. Bactericidal noncytotoxic dilutions of povidone-iodine and sodium hypochlorite were identified. These experiments provide evidence that 1% povidone-iodine, 3% hydrogen peroxide, 0.5% sodium hypochlorite, and 0.25% acetic acid are unsuitable for use in wound care. This sequence of experiments could be used to identify bactericidal, noncytotoxic agents prior to their clinical use.
Insights
Four common antiseptics are cytotoxic and may harm wound healing. Povidone-iodine and sodium hypochlorite show potential for wound care when used at non-cytotoxic dilutions.
Area of Science:
- Wound healing research
- Antiseptic and disinfectant efficacy
- Cellular toxicology
Background:
- Topical antiseptics are widely used in wound care.
- Assessing the cytotoxicity of these agents is crucial for patient safety and effective healing.
- Previous assessments may not have quantitatively compared bactericidal and cytotoxic effects.
Purpose of the Study:
- To quantitatively assess the cytotoxicity of common topical antibiotics and antiseptics on human fibroblasts.
- To evaluate the impact of these agents on wound healing in an animal model.
- To identify non-cytotoxic, bactericidal antiseptic dilutions for potential wound care applications.
Main Methods:
- Direct application of three topical antibiotics and four antiseptics (povidone-iodine, acetic acid, hydrogen peroxide, sodium hypochlorite) to cultured human fibroblasts.
- Quantitative assessment of cytotoxicity.
- In vivo wound healing assay in an animal model.
- Comparison of serial dilutions for bactericidal and cytotoxic effects.
Main Results:
- All four tested antiseptics (povidone-iodine, acetic acid, hydrogen peroxide, sodium hypochlorite) demonstrated cytotoxicity to human fibroblasts.
- Three of the four cytotoxic antiseptics (povidone-iodine, acetic acid, sodium hypochlorite) adversely affected wound healing in an animal model.
- Cytotoxicity of hydrogen peroxide and acetic acid exceeded their bactericidal potency.
- Non-cytotoxic, bactericidal dilutions were identified for povidone-iodine and sodium hypochlorite.
Conclusions:
- 1% povidone-iodine, 3% hydrogen peroxide, 0.5% sodium hypochlorite, and 0.25% acetic acid are unsuitable for wound care due to cytotoxicity.
- Povidone-iodine and sodium hypochlorite possess bactericidal and non-cytotoxic properties at specific dilutions, indicating potential for wound management.
- The study proposes a methodology for identifying safe and effective topical antimicrobial agents for clinical use.