ANTISEPSIS

KINDS OF ANTISEPSIS

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 BIOLOGICAL ANTISEPSIS
• ANTIBIOTICS
• PROTEOLYTIC ENZYMES
• VACCINE
• HYPERIMMUNE SERUM
• IMMUNOGLOBULINS
• IMMUNOSTIMULATORS

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 Pathogenic microorganisms of
surgical infections
• gram positive and gram negative
• Aerobic and anaerobic

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 Pathogenic microorganisms
• Gram-positive cocci / one of major causative
organisms of surgical infections/:
staphylococci, streptococci, enterococci,
pnrumococci
• Gram-positive class / are less important in
surgery /: mycobacteria, spirochete,leptospira
• Gram-positive anaerobic cocci –
peptostreptococci
• Gram-positive anaerobic class – clostridium,
bifidobacteri

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 Pathogenic microorganisms
• Gram-negative cocci: actinobacter, neisseria
• Gram- negative class / often causative
organisms of a surgical infections/: E.coli and
pseudomonas, klebsiella, enterobacter,
salmonella, Helicobacter pylory
• Gram-negative anaerobic coccuses - beilonella
• Gram-negative anaerobic class – bacteroids,
fusobactery

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 Pathogenic microorganisms
• Sensitivity to a drug – • Resistance – is the
is the inhibition preservation of
growth of growth's ability
microorganism in microorganism in
therapeutic therapeutic
concentrations of concentrations of
antibiotics antibiotics: primary/
before treatment with
drug/ or
secondary/after
treatment with drug/
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 ANTIBIOTICS
• Penicillins:
Natural penicillines / benzylpenicilline, bicilline,
phenoxymethylpenicilline
Antistaphyloccoal – oxacilline, dicloxacine / are active
against G+: staphyloccocal infections – pneumonia, lung
abscess, osteomyelitis, abscess and phlegmon of soft
tissues
• Aminopenicillines – ampicilline, amoxycilline
combined – ampiox / ampicilline + oxacilline
antipseudomonas – carboxypenicilines, aslocilline
protected from lactamase – amoxyclav, tasocine / are
effective against G-: pseudomonas, proteus – burns,
peritonitis
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 ANTIBIOTICS

• Cephalosporins
• 1 generation/ cefalexinum/ G-, not lactomase activity

• 2 generation – cephaloridin, kefsol/ are stable to

lactomase, spectrum – G+ and G- microorganisms
• 3 generation – cefotaxim, cefaperazon are stable to
lactomase, spectrum – G- microorganisms, anaerobic
microorganism
• 4 generation – cefepin, cefperoson are stable to
lactomase, spectrum – G+ and G- microorganisms,
anaerobic microorganisms
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 ANTIBIOTICS
• Aminoglycosides –gentamicin, kanamycin,
amikacin/ have broad spectrum against G+,G-
and anaerobic microorganism
• Tetracyclines – tetracycline, rondomicin,
vibramicin have broad spectrum against G+,G-
and anaerobic microorganism
• Macrolides – erytromycin, oleandomycin,
azitromycin/ G+, helicobacter
• Fluorquinolones – ofloxacin, pefloxacin have
broad spectrum against G+,G- and anaerobic
microorganism/ E. coli,
enterobacteriaceae,klebsiella
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 Routes of administration
• Peroral \only in mild infection
• Intramuscular \ in most surgical infections
• Itravenous \ to achieve high concentration
in the blood
• Intraarterial \ to achieve high concentration
in the blood + short time
• Local application

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 Biologic antiseptic compounds
• Proteolytic enzymes can lyse necrotic
tissues. Usually used proteolytic enzymes
of animal origin are trypsin, chymotypsin,
ribonuclease;
• those of bacterial origin – terrilitin,
streptokinase, collagenase, asperase,
ribonuclease, iruxol;
• plant origin- papain and bromelain.

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 IMMUNE STIMULATORS
• Improve non-specific immune defence
• Prodigiosan \ dificit B lymphocytes\
• Levamisol \ dificit T lymphocytes\

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 IMMUNIZATION
immunization
• Active • Passive
• Staphylococcal • Antistaphyloccocal
anatoxin hyperimmune plasma/
• Tetanus anatoxin of donors` blood/
• Antistaphyloccocal
Gamma globulin/ from
donor's blood
• Antitetanus serum /
from horse's blood

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 Tetanus / emergency
prophylaxis/
• Immunised patients: 0,5 ml toxoid as a single
dose
• Non- immunised patients: 1,0 ml
toxoid + 1,500-3,000 IU Antitenanus serum/
450-600 IU Antitetanus gamma globulin/
• After 1 month - 0,5 ml toxoid
• After 1 year - 0,5 ml toxoid

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 Tetanus
• Specific tetanus prophylaxis: 0,5 ml of
toxoid are given twice a month
REVACCINATION is done after 1 year -
0,5 ml of toxoid
• Repeaded REVACCINATION after 5
years - 0,5 ml toxoid`

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