Since 1987, octenidine has been used in Europe as an antiseptic, in concentrations of 0.1 to 2.0%.[citation needed] It is a substitute for chlorhexidine, with respect to its slow action and concerns about the carcinogenic impurity 4-chloroaniline.[citation needed]
Octenidine preparations are less expensive than chlorhexidine and no resistance had been observed as of 2007. They may contain the antiseptic phenoxyethanol. It is not listed in the Annex V of authorized preservatives of the European Cosmetic Regulation 1223/2009.
In vitro suspension tests with 5 minute exposure time have shown that octenidine requires lower effective concentrations than chlorhexidine to kill common bacteria like Staphylococcus aureus, Escherichia coli, Proteus mirabilis and the yeast Candida albicans.
Comparison between octenidine and chlorhexidine determined by the suspension test after 5 minutes of exposure.
An observational study of using octenidine on the skin of patients in 17 intensive care units in Berlin in 2014 showed decreasing nosocomial infection rates.
In a survey of German neonatal intensive-care units octenidine without phenoxyethanol and octenidine were the most common skin antiseptics used for intensive-care procedures. Skin complications included blistering, necrosis and scarring, which has not been previously reported in this population.
In a 2016 study of pediatric cancer patients with long-term central venous access devices using octenidine/isopropanol for the disinfection of catheter hubs and 3-way stopcocks as part of a bundled intervention, the risk of bloodstream infections decreased.
Safety
In a 2016 in vitro study of mouth rinses on gingival fibroblasts and epithelial cells octenidine showed a less cytotoxic effect, especially on epithelial cells, compared to chlorhexidine after 15 min.
Wound irrigation with octenidine has caused severe complications in dogs, aseptic necrosis and chronic inflammation in penetrating hand wounds in humans.
Synthesis
The secondary amine (3) is formed by reaction of octan-1-amine (1) and 4-bromopyridine (2). Treatment of this with 1,10-dichlorodecane (4) yields octenidine as its dihydrochloride salt.
12C.D. Biermann; A. Kribs; B. Roth; I. Tantcheva-Poor (2016). "Use and Cutaneous Side Effects of Skin Antiseptics in Extremely Low Birth Weight Infants - A Retrospective Survey of the German NICUs". Klinische Pädiatrie. 228 (4): 208–12. doi:10.1055/s-0042-104122. PMID27362412. S2CID5099338.
↑Kaiser, S.; Kramer, M.; Thiel, C. (2015). "Severe complications after non-intended usage of octenidine dihydrochloride. A case series with four dogs". Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere. 43 (5): 291–298. doi:10.15654/TPK-150029. PMID26353826. S2CID80926611.
↑USpatent 4206215,Denis M. Bailey,"Antimicrobial bis-[4-(substituted-amino)-1-pyridinium]alkanes",issued 1980-06-03, assigned to Sterling Drug Inc
↑Bailey, Denis M.; DeGrazia, C. George; Hoff, Stephanie J.; Schulenberg, Patsy L.; O'Connor, John R.; Paris, Donald A.; Slee, Andrew McKenzie (1984). "Bispyridinamines: a new class of topical antimicrobial agents as inhibitors of dental plaque". Journal of Medicinal Chemistry. 27 (11): 1457–1464. doi:10.1021/jm00377a014. ISSN0022-2623. PMID6492075.