title: Dimethyl sulfoxide enhances effectiveness of skin antiseptics and reduces contamination rates of blood cultures.
abstract: Effective skin antisepsis is of central importance in the prevention of wound infections, colonization of medical devices, and nosocomial transmission of microorganisms. Current antiseptics have a suboptimal efficacy resulting in substantial infectious morbidity, mortality, and increased health care costs. Here, we introduce an in vitro method for antiseptic testing and a novel alcohol-based antiseptic containing 4 to 5% of the polar aprotic solvent dimethyl sulfoxide (DMSO). The DMSO-containing antiseptic resulted in a 1- to 2-log enhanced killing of Staphylococcus epidermidis and other microbes in vitro compared to the same antiseptic without DMSO. In a prospective clinical validation, blood culture contamination rates were reduced from 3.04% for 70% isopropanol-1% iodine (control antiseptic) to 1.04% for 70% isopropanol-1% iodine-5% DMSO (P < 0.01). Our results predict that improved skin antisepsis is possible using new formulations of antiseptics containing strongly polarized but nonionizing (polar aprotic) solvents.
authors.affiliation: Department of Laboratory Medicine, The University of Texas M D Anderson Cancer Center, Houston, Texas, USA. jtarrand@mdanderson.org
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Tarrand
authors.forename: Paul R
authors.initials: PR
authors.lastname: LaSala
authors.forename: Xiang-Yang
authors.initials: XY
authors.lastname: Han
authors.forename: Kenneth V
authors.initials: KV
authors.lastname: Rolston
authors.forename: Dimitrios P
authors.initials: DP
authors.lastname: Kontoyiannis
mesh_terms: D019840:2-Propanol / Q000494:pharmacology; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D058491:Bacterial Load; D001769:Blood / Q000382:microbiology*; D004121:Dimethyl Sulfoxide / Q000494:pharmacology*; D004357:Drug Synergism; D005260:Female; D006801:Humans; D007455:Iodine / Q000494:pharmacology; D008297:Male; D050296:Microbial Viability / Q000187:drug effects; D008875:Middle Aged; D012867:Skin / Q000382:microbiology*; D013212:Staphylococcus epidermidis / Q000187:drug effects
chemical_list: D000891:Anti-Infective Agents, Local; D007455:Iodine; D019840:2-Propanol; D004121:Dimethyl Sulfoxide