[Antiseptics in otorhinolaryngology-a substance overview].
Antiseptika in der HNO-Heilkunde – eine Substanzübersicht.
MRSA
Otitis
Pharyngitis
Rhinosinusitis
Wound infection
Journal
HNO
ISSN: 1433-0458
Titre abrégé: HNO
Pays: Germany
ID NLM: 2985099R
Informations de publication
Date de publication:
09 Apr 2024
09 Apr 2024
Historique:
accepted:
07
03
2024
medline:
9
4
2024
pubmed:
9
4
2024
entrez:
9
4
2024
Statut:
aheadofprint
Résumé
For preoperative skin antisepsis, alcohol-containing iodine solutions and octenidine are suitable. For wound antisepsis, polyhexanide and hypochlorous acid (HOCL) are also available, but only PVP-iodine and HOCL can be applied to cartilage. Chlorhexidine should only be used as mouth- and bodywash for Staphylococcus aureus (MRSA) decolonization. For the many other throat antiseptics, evidence of clinical efficacy is lacking. For decolonization of the nares, polyhexanide and octenidine are available as nasal gels, but these are inferior to mupirocin for MRSA decolonization. PVP-iodine and HOCL are safe to use for nasal irrigation, but only HOCL has proven effective to improve symptoms of chronic rhinosinusitis. All antiseptics exhibit a certain ototoxicity. With an intact eardrum, acetic acid-containing eardrops can be used to prevent and treat external otitis and myringitis. When the eardrum is perforated, only alcohol-free PVP-iodine and HOCL may be used. Zur präoperativen Hautantisepsis eignen sich alkoholhaltige Jodlösung und Octenidin, für Wundantisepsis zudem Polihexanid und hypochlorige Säure (HOCl), wobei nur Povidon(PVP)-Jod und HOCl mit Knorpel in Kontakt kommen darf. Chlorhexidin sollte nur noch als Mundspüllösung und Körperwaschlotion zur Dekolonisierung bei multiresistentem Staphylococcus aureus (MRSA) angewendet werden. Für die zahlreichen weiteren Rachenantiseptika fehlen Studien zum klinischen Nutzen. Zur Dekolonisierung der Nasenvorhöfe gibt es Polihexanid und Octenidin als Nasen-Gele, sie sind in der MRSA-Dekolonisierung jedoch Mupirocin unterlegen. Zur Nasendusche eignen sich Jodlösung und HOCl, wobei für HOCl ein Nutzen bei chronischer Rhinosinusitis belegt ist. Alle Antiseptika sind mehr oder weniger ototoxisch. Bei intaktem Trommelfell können Isopropylalkohol-Essigsäure-Kombinationen zur Prophylaxe und Therapie der Otitis externa und Myringitis eingesetzt werden, bei perforiertem Trommelfell alkoholfreie Jodlösung und HOCl.
Autres résumés
Type: Publisher
(ger)
Zur präoperativen Hautantisepsis eignen sich alkoholhaltige Jodlösung und Octenidin, für Wundantisepsis zudem Polihexanid und hypochlorige Säure (HOCl), wobei nur Povidon(PVP)-Jod und HOCl mit Knorpel in Kontakt kommen darf. Chlorhexidin sollte nur noch als Mundspüllösung und Körperwaschlotion zur Dekolonisierung bei multiresistentem Staphylococcus aureus (MRSA) angewendet werden. Für die zahlreichen weiteren Rachenantiseptika fehlen Studien zum klinischen Nutzen. Zur Dekolonisierung der Nasenvorhöfe gibt es Polihexanid und Octenidin als Nasen-Gele, sie sind in der MRSA-Dekolonisierung jedoch Mupirocin unterlegen. Zur Nasendusche eignen sich Jodlösung und HOCl, wobei für HOCl ein Nutzen bei chronischer Rhinosinusitis belegt ist. Alle Antiseptika sind mehr oder weniger ototoxisch. Bei intaktem Trommelfell können Isopropylalkohol-Essigsäure-Kombinationen zur Prophylaxe und Therapie der Otitis externa und Myringitis eingesetzt werden, bei perforiertem Trommelfell alkoholfreie Jodlösung und HOCl.
Identifiants
pubmed: 38592477
doi: 10.1007/s00106-024-01456-5
pii: 10.1007/s00106-024-01456-5
doi:
Types de publication
English Abstract
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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