Cetrimide 1% cream

Background: Endometritis, maternal fever and wound infection represent the most frequent post-cesarean complications. The aim of the present research was to evaluate the incidence of post-cesarean infections after vaginal cleansing. Materials and methods: The databases analyzed were MEDLINE, Scopus, EMBASE, CENTRAL, Google Scholar, Clinicaltrials.gov and the Register of Controlled Trials. No language or geographical restrictions were applied. We included only randomized controlled trials that analyzed various vaginal antiseptic solutions to reduce postpartum endometritis. The terms employed were as follows: vaginal solution, cesarean section, endometritis, wound infection, chlorhexidine, povidone, metronidazole, cetrimide, and pregnancy. The PICO categorization was as follows: P-population: pregnant women; I-intervention: vaginal antiseptic; C-control: hands-off or routine care; O-outcome: post-cesarean endometritis, wound infection and postoperative fever; S-study design: randomized controlled trials. Results: A total of 32 articles, including 13,853 participants, were selected. The vaginal cleansing group showed a low incidence of endometritis. The chlorhexidine group had an OR of 0.56 (95% CI 0.45-0.70, p = 0.010). The povidone group had an OR of 0.47 (95% CI 0.37-0.59, p = 0.002). Considering maternal fever, 2598 patients from 5 studies in the chlorhexidine group were analyzed, alongside 6965 patients from 18 trials in the povidone group. The povidone group presented an Odds ratio of 0.47 (95% CI 0.38-0.57, p = 0.0001). A reduction in wound infection incidence was observed in the povidone group (OR = 0.59, 95% CI = 0.42-0.82, p Conclusions: Vaginal cleansing before cesarean section, particularly with povidone solutions, reduces the incidence of postoperative endometritis and maternal fever.

Abstract licence: CC BY

The recent global pandemic has resulted in increased use of quaternary ammonium compounds (QACs). Currently, QACs are active ingredients in 292 disinfectants recommended by the US EPA for use against SARS-CoV-2. Among QACs, benzalkonium chloride (BAK), cetrimonium bromide (CTAB), cetrimonium chloride (CTAC), didecyldimethylammonium chloride (DDAC), cetrimide, quaternium-15, cetylpyridinium chloride (CPC), and benzethonium chloride (BEC) were all identified as potential culprits of skin sensitivity. Given their widespread utilization, additional research is needed to better classify their dermal effects and identify other cross-reactors. In this review, we aimed to expand our knowledge about these QACs to further dissect its potential allergic and irritant dermal effects on healthcare workers during COVID-19.

Abstract licence: CC BY-NC

PurposeTo provide an overview of artificial tears marketed in the following Nordic countries: Denmark, Finland, Norway, Iceland and Sweden. Furthermore, this review aimed to highlight the different preservatives and other constituents found in artificial tears in the Nordic market, focussing on adverse effects.MethodsArtificial tears appearing in online pharmacies in Denmark, Norway, Sweden, Finland and Iceland were included, and tables listing their components were created. Based on the preservatives and other constituents found in the artificial tears on the Nordic market, a literature search was conducted to investigate differences and potential adverse effects. This was achieved using PubMed with MeSH and free text search terms. Included articles were (i) studies performed on humans in vivo or in vitro human models, (ii) published between 2000 and 2023 and (iii) focussing on adverse effects, preservatives, toxicity, other constituents and preservative-free artificial tears.ResultsA total of 88 artificial tears were found on the Nordic market. Approximately 32% (28 out of 88) of the artificial tears contain preservatives. Eleven of these are preserved with benzalkonium chloride (BAK) or cetrimide. After a thorough literature search, evidence has been found for the toxic effects of BAK and cetrimide. There is no evidence of toxic effects of lubricants, osmoprotectants and lipids.ConclusionsThe findings of this review highlight the paradoxical fact that many treatments for ocular surface diseases contain toxic preservatives that may lead to worsening of the condition. In particular, long-time toxic effects of BAK may contribute to disease progression.

Abstract licence: CC BY-NC-ND