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Clinical Therapeutics

Alcohols for Skin Antisepsis at Clinically Relevant Skin Sites

Mirja Reichel, Peter Heisig, Thomas Kohlmann, Günter Kampf
Mirja Reichel
1Bode Chemie GmbH, Scientific Affairs, Melanchthonstr. 27, 22525 Hamburg, Germany
2Department of Pharmaceutical Biology and Microbiology, Institute of Pharmacy, University of Hamburg, 20146 Hamburg, Germany
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  • For correspondence: mirja.reichel@bode-chemie.de
Peter Heisig
2Department of Pharmaceutical Biology and Microbiology, Institute of Pharmacy, University of Hamburg, 20146 Hamburg, Germany
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Thomas Kohlmann
3Institute of Community Medicine, Ernst Moritz Arndt University, Walther-Rathenau-Str. 49a, 17487 Greifswald, Germany
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Günter Kampf
1Bode Chemie GmbH, Scientific Affairs, Melanchthonstr. 27, 22525 Hamburg, Germany
4Institute for Hygiene and Environmental Medicine, Ernst Moritz Arndt University, Walther-Rathenau-Str. 48, 17487 Greifswald, Germany
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DOI: 10.1128/AAC.00582-09
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Tables

  • TABLE 1.

    Mean log10 reduction of the skin flora on different skin sites by various alcohols after different application times

    Skin siteType of alcoholaConcn (%)Mean ± SD log10 reduction and P value at indicated time (min)a
    2P value3P value4P value
    Foreheadprop-1601.54A/AA ± 0.94<0.0011.93B/BB ± 0.73<0.0011.74C ± 1.260.044
    prop-20.67AA ± 0.650.78BB ± 0.791.05 ± 0.88
    eth0.40A ± 0.540.79B ± 0.600.83C ± 1.31
    Upper backprop-11.90D ± 0.690.0202.08 ± 0.750.2922.16 ± 0.970.596
    prop-21.38 ± 0.951.72 ± 0.921.87 ± 0.97
    eth1.09D ± 1.021.69 ± 0.952.08 ± 0.80
    Abdomenprop-12.25 ± 0.590.4342.63E ± 0.740.0032.56 ± 0.770.182
    prop-22.16 ± 0.772.13 ± 1.072.14 ± 0.94
    eth1.94 ± 0.971.67E ± 0.652.10 ± 0.86
    Lumbar areaprop-11.93 ± 0.600.7541.81 ± 0.550.6311.82 ± 0.780.595
    prop-21.79 ± 0.591.84 ± 0.571.97 ± 0.80
    eth1.87 ± 0.611.67 ± 0.601.72 ± 0.77
    Foreheadprop-1701.73F ± 0.920.0241.90G/GG ± 0.810.0011.89H ± 0.910.026
    prop-21.21 ± 0.651.26GG ± 0.541.18H ± 0.84
    eth0.98F ± 0.711.08G ± 0.641.23 ± 0.98
    Upper backprop-11.81 ± 0.640.6231.97 ± 1.360.8062.53J/JJ ± 0.910.002
    prop-21.69 ± 0.801.81 ± 0.991.67JJ ± 0.83
    eth1.56 ± 1.001.74 ± 1.051.49J ± 1.07
    Abdomenprop-12.40 ± 0.640.2452.69 ± 0.890.2352.73K/KK ± 0.810.002
    prop-22.43 ± 0.722.23 ± 0.951.69KK ± 1.11
    eth2.07 ± 0.832.55 ± 0.772.02K ± 0.80
    Lumbar areaprop-12.18 ± 0.510.3642.10 ± 0.650.6282.00 ± 0.860.731
    prop-22.12 ± 0.531.91 ± 0.601.90 ± 1.12
    eth1.94 ± 0.581.93 ± 0.741.76 ± 1.01
    Foreheadprop-189.51.82 ± 1.240.1322.09 ± 1.330.4032.38L ± 1.170.002
    prop-21.44 ± 1.031.70 ± 0.931.88 ± 0.88
    eth1.17 ± 0.711.60 ± 0.941.34L ± 0.52
    Upper backprop-12.25M ± 0.750.0062.13 ± 0.530.4452.59 ± 0.900.068
    prop-21.89 ± 0.912.00 ± 0.591.91 ± 1.07
    eth1.40M ± 0.742.27 ± 0.852.02 ± 0.93
    Abdomenprop-12.54 ± 0.710.8882.53 ± 0.970.7222.70 ± 0.970.070
    prop-22.43 ± 0.712.51 ± 0.852.29 ± 0.90
    eth2.50 ± 0.782.32 ± 0.981.99 ± 1.02
    Lumbar areaprop-12.14 ± 0.550.6792.05 ± 0.690.7932.36 ± 0.590.302
    prop-22.03 ± 0.522.15 ± 0.542.26 ± 0.61
    eth1.98 ± 0.682.01 ± 0.772.06 ± 0.65
    • ↵ a prop-1, n-propanol; prop-2, isopropanol; eth, ethanol.

    • b Different superscript uppercase characters (A to M) represent significant differences in post hoc analysis results between the different types of alcohol. Single and double superscript uppercase characters are used whenever a significant difference was found between two pairs of means. Each mean value represents data from 20 different subjects.

  • TABLE 2.

    Ranking of parameters with influence on the reduction of skin flora on different skin sites (n = 180)

    Skin siteParameter ranking (highest influence to lowest influence)
    ForeheadType of alcohol (P < 0.001) > concn (P < 0.001) > application time (P = 0.006)
    Upper backType of alcohol (P < 0.001) > application time (P < 0.001) > concn (P = 0.006)
    AbdomenType of alcohol (P < 0.001) > concn (P = 0.024) > application time (n.s.a)
    Lumbar areaConcn (P < 0.001) > type of alcohol (n.s.)/application time (n.s.)
    • ↵ a n.s., not significant.

  • TABLE 3.

    Mean log10 reduction and suppression of recolonization of skin flora after 72 h of coverage (n = 20)

    Skin siteMean log10 baseline count (CFU/cm2)Application timeImmediate log10 reduction of n-propanol (89.5%)Suppression of recolonization (expressed as log10 difference from baseline count after 72 h of sterile coverage) in n-propanol solution (89.5% [vol/vol]) supplemented witha:
    No supplementation0.5% CHG1% CHG2% CHG
    Upper arms2.36 ± 0.7730 s2.06 ± 0.590.41Δ/*/** ± 1.341.33Δ ± 1.291.16* ± 1.231.24** ± 0.96
    Upper back2.94 ± 0.943 min2.14 ± 0.850.28▴/° ± 1.461.07▴ ± 1.811.42 ± 1.431.30° ± 1.56
    • ↵ a Different superscript characters represent significant differences of means for each skin site in post hoc analysis results.

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Alcohols for Skin Antisepsis at Clinically Relevant Skin Sites
Mirja Reichel, Peter Heisig, Thomas Kohlmann, Günter Kampf
Antimicrobial Agents and Chemotherapy Oct 2009, 53 (11) 4778-4782; DOI: 10.1128/AAC.00582-09

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Alcohols for Skin Antisepsis at Clinically Relevant Skin Sites
Mirja Reichel, Peter Heisig, Thomas Kohlmann, Günter Kampf
Antimicrobial Agents and Chemotherapy Oct 2009, 53 (11) 4778-4782; DOI: 10.1128/AAC.00582-09
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KEYWORDS

Alcohols
Anti-Infective Agents, Local
skin

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