Comparison of the in vivo and in vitro antibacterial properties of antiseptic mouthrinses containing chlorhexidine, alexidine, cetyl pyridinium chloride and hexetidine. Relevance to mode of action. 1981

W R Roberts, and M Addy

A study was carried out to compare the antibacterial properties of four cationic antiseptics, three of which are available as commercial mouthrinse preparations. Minimum inhibitory concentrations for alexidine, cetyl pyridinium chloride, chlorhexidine gluconate and hexetidine against a range of standard test organisms, were determined by tube dilution. Similar values for Oxford staphylococcus were then obtained in Dubos medium to which protein as yeast, or food extract, or serum was added in doubling dilutions to 16%. Salivary bacterial counts after a single rinse with the antiseptics or water throughout the day were measured in 10 subjects together with the duration of any residual antiseptic activity in the saliva. All antiseptics were effective at low concentrations against the organisms tested but the minimum inhibitory concentration values for hexetidine were the highest. Food extract and serum markedly increased the minimum inhibitory concentration values of all antiseptics, although alexidine and hexetidine were the least affected in percentage terms. The activity of a 1% povidone iodine preparation, used for comparison, was almost completely vitiated. An immediate significant fall in salivary bacterial counts was produced by the cationic antiseptics. Return to pre-rinse levels was seen for hexetidine after 90 min, cetyl pyridinium chloride after 3 hours, alexidine after 5 hours and chlorhexidine gluconate after 7 hours. Residual salivary antibacterial activity remained to 90 min for cetyl pyridinium chloride, to 3 hours for hexetidine and alexidine and to 5 hours for chlorhexidine gluconate. The antibacterial properties measured, in particular the duration of effect in vivo, may be relevant to the anti-plaque activity of cationic antiseptics.

UI MeSH Term Description Entries
D009067 Mouthwashes Solutions for rinsing the mouth, possessing cleansing, germicidal, or palliative properties. (From Boucher's Clinical Dental Terminology, 4th ed) Mouth Bath,Mouth Rinse,Mouth Wash,Bath, Mouth,Baths, Mouth,Mouth Baths,Mouth Rinses,Rinse, Mouth,Rinses, Mouth,Wash, Mouth
D011726 Pyridinium Compounds Derivatives of PYRIDINE containing a cation C5H5NH or radical C5H6N. Compounds, Pyridinium
D002594 Cetylpyridinium Cationic bactericidal surfactant used as a topical antiseptic for skin, wounds, mucous membranes, instruments, etc.; and also as a component in mouthwash and lozenges. Angifonil,Biosept,Catamium,Ceepryn Chloride,Cetamium,Cetylpyridinium Chloride,Cetylpyridinium Chloride Anhydrous,Cetylpyridium,Cetylyre,Dobendan,Hexadecylpyridinium,Merocets,Pristacin,Pyrisept,Sterogenol,Anhydrous, Cetylpyridinium Chloride,Chloride Anhydrous, Cetylpyridinium,Chloride, Ceepryn,Chloride, Cetylpyridinium
D002710 Chlorhexidine A disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. Chlorhexidine Acetate,Chlorhexidine Hydrochloride,MK-412A,Novalsan,Sebidin A,Tubulicid,Acetate, Chlorhexidine,Hydrochloride, Chlorhexidine,MK 412A,MK412A
D003470 Culture Media Any liquid or solid preparation made specifically for the growth, storage, or transport of microorganisms or other types of cells. The variety of media that exist allow for the culturing of specific microorganisms and cell types, such as differential media, selective media, test media, and defined media. Solid media consist of liquid media that have been solidified with an agent such as AGAR or GELATIN. Media, Culture
D006590 Hexetidine A bactericidal and fungicidal antiseptic. It is used as a 0.1% mouthwash for local infections and oral hygiene. (From Martindale, The Extra Pharmacopoeia, 30th ed, p797) Bactidol,Doreperol,Duranil,Elsix,Hexigel,Hexoral,Hextril,Oraldene,Oraldine,Steri-sol
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001419 Bacteria One of the three domains of life (the others being Eukarya and ARCHAEA), also called Eubacteria. They are unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. Bacteria can be classified by their response to OXYGEN: aerobic, anaerobic, or facultatively anaerobic; by the mode by which they obtain their energy: chemotrophy (via chemical reaction) or PHOTOTROPHY (via light reaction); for chemotrophs by their source of chemical energy: CHEMOLITHOTROPHY (from inorganic compounds) or chemoorganotrophy (from organic compounds); and by their source for CARBON; NITROGEN; etc.; HETEROTROPHY (from organic sources) or AUTOTROPHY (from CARBON DIOXIDE). They can also be classified by whether or not they stain (based on the structure of their CELL WALLS) with CRYSTAL VIOLET dye: gram-negative or gram-positive. Eubacteria
D001645 Biguanides Derivatives of biguanide (the structure formula HN(C(NH)NH2)2) that are primarily used as oral HYPOGLYCEMIC AGENTS for the treatment of DIABETES MELLITUS, TYPE 2 and PREDIABETES. Biguanide
D012463 Saliva The clear, viscous fluid secreted by the SALIVARY GLANDS and mucous glands of the mouth. It contains MUCINS, water, organic salts, and ptylin. Salivas

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