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JAC Advance Access published online on March 25, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkn125
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Original research

Biocompatibility index of antiseptic agents by parallel assessment of antimicrobial activity and cellular cytotoxicity

Gerald Müller and Axel Kramer*

Institute of Hygiene and Environmental Medicine, University of Greifswald, W.-Rathenau-Str. 49a, D-17487 Greifswald, Germany

Received 16 October 2007; returned 12 February 2008; revised 28 November 2008; accepted 29 February 2008

* Corresponding author. Tel: +49-3834-515542; Fax: +49-3834-515541; E-mail: kramer{at}uni-greifswald.de

Objectives: To assess the suitability of an antiseptic agent, both the microbicidal activity and the cytotoxic effect must be taken into consideration to derive biocompatible antibacterial agents.

Methods: We defined the biocompatibility index (BI) by measuring the antibacterial activity against the test organisms Escherichia coli and Staphylococcus aureus and, in parallel, the cytotoxicity on cultured murine fibroblasts. The antiseptic agents tested were benzalkonium chloride (BAC), cetylpyridinium chloride (CPC), chlorhexidine digluconate (CHX), mild silver protein (MSP), octenidine dihydrochloride (OCT), polyhexamethylene biguanide (PHMB), povidone iodine in solution [PVP-I(s)], povidone iodine in ointment [PVP-I(o)], silver nitrate (AgNO3), silver (I) sulfadiazine (SSD) and triclosan (TRI). Assays were carried out for 30 min of exposure at 37°C in the presence of cell culture medium containing 10% fetal bovine serum. The resulting dimensionless BI was defined as the ratio of the concentration at which 50% of the murine fibroblasts are damaged and the microbicidal effect producing at least 3 log10 (99.9%) reduction.

Results: The resulting rank ordering of BI for the ratio of fibroblast cytotoxicity to E. coli toxicity was OCT > PHMB > CHX > PVP-I(o) > PVP-I(s) > BAC > CPC > TRI > MSP and that to S. aureus was OCT > PHMB > CHX > CPC > PVP-I(o) > BAC > PVP(s) > TRI > MSP. OCT and PHMB were the most suitable agents with a BI greater than 1.

Conclusions: The BI presented may be a useful tool to evaluate antiseptic agents for use in clinical practice.

Key Words: antibacterial effectiveness , rank ordering , in vitro


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