title: Proposed phase 2/ step 2 in-vitro test on basis of EN 14561 for standardised testing of the wound antiseptics PVP-iodine, chlorhexidine digluconate, polihexanide and octenidine dihydrochloride.
abstract: Currently, there is no agreed standard for exploring the antimicrobial activity of wound antiseptics in a phase 2/ step 2 test protocol. In the present study, a standardised in-vitro test is proposed, which allows to test potential antiseptics in a more realistically simulation of conditions found in wounds as in a suspension test. Furthermore, factors potentially influencing test results such as type of materials used as test carrier or various compositions of organic soil challenge were investigated in detail.
  
  
  
  This proposed phase 2/ step 2 test method was modified on basis of the EN 14561 by drying the microbial test suspension on a metal carrier for 1 h, overlaying the test wound antiseptic, washing-off, neutralization, and dispersion at serial dilutions at the end of the required exposure time yielded reproducible, consistent test results.
  
  
  
  The difference between the rapid onset of the antiseptic effect of PVP-I and the delayed onset especially of polihexanide was apparent. Among surface-active antimicrobial compounds, octenidine was more effective than chlorhexidine digluconate and polihexanide, with some differences depending on the test organisms. However, octenidine and PVP-I were approximately equivalent in efficiency and microbial spectrum, while polihexanide required longer exposure times or higher concentrations for a comparable antimicrobial efficacy.
  
  
  
  Overall, this method allowed testing and comparing differ liquid and gel based antimicrobial compounds in a standardised setting.
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine, Greifswald, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Schedler
authors.affiliation: Institute for Sin Integrity and Infection Prevention, School of Human and Health Sciences, University of Huddersfield, R1/29 Ramsden Building, Queensgate, Huddersfield, HD1 3DH, UK. Ojan.assadian@meduniwien.ac.at.
authors.forename: Ojan
authors.identifier: 0000-0003-0129-8761
authors.initials: O
authors.lastname: Assadian
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine, Greifswald, Germany.
authors.forename: Uta
authors.initials: U
authors.lastname: Brautferger
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine, Greifswald, Germany.
authors.forename: Gerald
authors.initials: G
authors.lastname: Müller
authors.affiliation: Hygiene Nord GmbH, Greifswald, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Koburger
authors.affiliation: Department for Vascular Surgery, Kerckhoff-Klinik GmbH, Bad Nauheim, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Classen
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine, Greifswald, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Kramer
mesh_terms: D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D001645:Biguanides / Q000494:pharmacology; D002710:Chlorhexidine / Q000031:analogs & derivatives / Q000494:pharmacology; D016984:Enterococcus faecium / Q000187:drug effects*; D006801:Humans; D007097:Imines; D066298:In Vitro Techniques; D008826:Microbial Sensitivity Tests / Q000379:methods* / Q000592:standards*; D050296:Microbial Viability / Q000187:drug effects; D011206:Povidone-Iodine / Q000494:pharmacology; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D011725:Pyridines / Q000494:pharmacology; D013211:Staphylococcus aureus / Q000187:drug effects*; D013997:Time Factors
chemical_list: D000891:Anti-Infective Agents, Local; D001645:Biguanides; D007097:Imines; D011725:Pyridines; C031233:polihexanide; D011206:Povidone-Iodine; C010882:chlorhexidine gluconate; C034213:octenidine; D002710:Chlorhexidine
keywords: Bactericidal efficacy; Chlorhexidine digluconate; EN 14561; Octenidine dihydrochloride; PVP-iodine; Polyhexanide; Wound antisepsis; Yeasticidal efficacy