Octenidine dihydrochloride explained

Octenidine dihydrochloride is a cationic surfactant, with a gemini-surfactant structure, derived from 4-aminopyridine. It is active against Gram-positive and Gram-negative bacteria. Since 1987, it has been used primarily in Europe as an antiseptic prior to medical procedures, including on neonates.

Medical uses

Since 1987, octenidine has been used in Europe as an antiseptic, in concentrations of 0.1 to 2.0%. It is a substitute for chlorhexidine, with respect to its slow action and concerns about the carcinogenic impurity 4-chloroaniline. Octenidine preparations are less expensive than chlorhexidine and no resistance had been observed as of 2007.[1] They may contain the antiseptic phenoxyethanol. It is not listed in the Annex V of authorized preservatives of the European Cosmetic Regulation 1223/2009.

Efficacy

Octenidine dihydrochloride is active against Gram-positive and Gram-negative bacteria.[2]

In vitro suspension tests with 5 minute exposure time have shown that octenidine requires lower effective concentrations than chlorhexidine to kill common bacteria like Staphylococcus aureus, Escherichia coli, Proteus mirabilis and the yeast Candida albicans.

 ! colspan="2"
Effective concentration, %
Octenidine dihydrochlorideChlorhexidine digluconate
Staphylococcus aureus0.025>0.2
Escherichia coli0.0250.1
Proteus mirabilis0.025>0.2
-Candida albicans0.010.025
Pseudomonas aeruginosa0.025>0.2
An observational study of using octenidine on the skin of patients in 17 intensive care units in Berlin in 2014 showed decreasing nosocomial infection rates.[3]

In a survey of German neonatal intensive-care units octenidine without phenoxyethanol and octenidine were the most common skin antiseptics used for intensive-care procedures. Skin complications included blistering, necrosis and scarring, which has not been previously reported in this population.[4]

In a 2016 study of pediatric cancer patients with long-term central venous access devices using octenidine/isopropanol for the disinfection of catheter hubs and 3-way stopcocks as part of a bundled intervention, the risk of bloodstream infections decreased.[5]

Safety

Octenidine is absorbed neither through the skin, nor through mucous membranes, nor via wounds and does not pass the placental barrier. However, cation-active compounds cause local irritation and are extremely poisonous when administered parenterally.

In a 2016 in vitro study of mouth rinses on gingival fibroblasts and epithelial cells octenidine showed a less cytotoxic effect, especially on epithelial cells, compared to chlorhexidine after 15 min.[6] Wound irrigation with octenidine has caused severe complications in dogs,[7] aseptic necrosis and chronic inflammation in penetrating hand wounds in humans.[8] [9]

Synthesis

The secondary amine (3) is formed by reaction of octan-1-amine [1) and 4-bromopyridine (2). Treatment of this with 1,10-dichlorodecane (4) yields octenidine as its dihydrochloride [[Salt (chemistry)|salt]].[10] [11] [12]

Notes and References

  1. Al-Doori . Z. . Goroncy-Bermes . P. . Gemmell . C. G. . Morrison . D. . June 2007 . Low-level exposure of MRSA to octenidine dihydrochloride does not select for resistance . The Journal of Antimicrobial Chemotherapy . 59 . 6 . 1280–1281 . 10.1093/jac/dkm092 . 0305-7453 . 17439976 . free.
  2. Sedlock . D M . Bailey . D M . December 1985 . Microbicidal activity of octenidine hydrochloride, a new alkanediylbis[pyridine] germicidal agent ]. Antimicrobial Agents and Chemotherapy . en . 28 . 6 . 786–790 . 10.1128/AAC.28.6.786 . 0066-4804 . 180329 . 3909955 . free.
  3. An observational study of the universal use of octenidine to decrease nosocomial bloodstream infections and MDR organisms. . Gastmeier P, Kämpf K, Behnke M, Geffers C, Schwab F . Journal of Antimicrobial Chemotherapy. 2016 . 71 . 9 . 2569–76 . 10.1093/jac/dkw170. 27234462 . free .
  4. Use and Cutaneous Side Effects of Skin Antiseptics in Extremely Low Birth Weight Infants - A Retrospective Survey of the German NICUs. . C.D. Biermann . A. Kribs . B. Roth . I. Tantcheva-Poor . Klinische Pädiatrie. 2016 . 228 . 4 . 208–12 . 10.1055/s-0042-104122. 27362412 . 5099338 .
  5. 10.3205/dgkh000258. 26605135. 4657435. 2015. Furtwängler. Rhoikos. Laux. Carolin. Graf. Norbert. Simon. Arne. Impact of a modified Broviac maintenance care bundle on bloodstream infections in paediatric cancer patients. GMS Hygiene and Infection Control . 10. Doc15.
  6. 10.3109/01480545.2015.1121274 . 26654138 . Cytotoxic effects of octenidine mouth rinse on human fibroblasts and epithelial cells – an in vitro study. 2016 . Schmidt . J. . Zyba . V. . Jung . K. . Rinke . S. . Haak . R. . Mausberg . R. F. . Ziebolz . D. . Drug and Chemical Toxicology . 39 . 3 . 322–330 . 19546288 .
  7. Kaiser, S. . Kramer, M. . Thiel, C. . Severe complications after non-intended usage of octenidine dihydrochloride. A case series with four dogs . Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere . 43 . 5 . 291–298 . 2015 . 10.15654/TPK-150029 . 26353826 . 80926611 .
  8. A comparison of the irritant and allergenic properties of antiseptics . European Journal of Dermatology . 2014 . 24 . 1 . Lachapelle . JM. . 3–9 . 10.1684/ejd.2013.2198 . 24492204 . free .
  9. Aseptic tissue necrosis and chronic inflammation after irrigation of penetrating hand wounds using Octenisept® . Franz . T. . Vögelin . E. . 2012 . The Journal of Hand Surgery, European Volume . 37 . 1 . 61–64 . subscription . 21816890 . 10.1177/1753193411414353 . 29175202 .
  10. US . 4206215 . Denis M. Bailey . Antimicrobial bis-[4-(substituted-amino)-1-pyridinium]alkanes . patent . 1980-06-03 . 1978-02-08 . 1978-02-08 . Sterling Drug Inc.
  11. Bailey . Denis M. . DeGrazia . C. George . Hoff . Stephanie J. . Schulenberg . Patsy L. . O'Connor . John R. . Paris . Donald A. . Slee . Andrew McKenzie . Bispyridinamines: a new class of topical antimicrobial agents as inhibitors of dental plaque . Journal of Medicinal Chemistry . 27 . 11 . 1984 . 0022-2623 . 10.1021/jm00377a014 . 1457–1464.
  12. Web site: Octenidine . Pharmaceutical Substances . Thieme . 2024-07-21.

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