Potassium loss from chlorhexidine-treated bacterial pathogens is time- and concentration-dependent and variable between species.

The membrane-active antimicrobial agent chlorhexidine is used extensively as an antiseptic during infection prophylaxis and treatment. Whilst known to induce membrane damage that results in loss of internal solutes from bacteria, the present study sought to determine the rate and extent of cytoplasmic potassium loss and whether any species-specific differences exist. Direct measurement of potassium was achieved using flame emission spectrophotometry. Exposure of selected species to minimum inhibitory (MIC) or minimum bactericidal concentration (MBC) resulted in solute loss that was both concentration and time dependent. Within 5-min treatment with MIC levels, losses of 3 % from P. aeruginosa, 9 % from E. coli, and 15 % from S. aureus were recorded, whilst at 5 % w/v chlorhexidine, elevated loss of 20, 28, and 41 % occurred, respectively. Nonlinear potassium release was evident from all species when treated with 5 % chlorhexidine over a 60-min period. After this contact time, potassium loss from E. coli and S. aureus rose to 93 or 90 %, respectively; in contrast, P. aeruginosa retained 62 % intracellular potassium. Results confirm lethal concentrations of chlorhexidine induce rapid and substantial loss of cytoplasmic potassium from common pathogens. However, bacterial responses vary between species and should be borne in mind when considering mechanism of action.

Rheological properties of gamma-irradiated antimicrobial wafers and in vitro efficacy against Pseudomonas aeruginosa.

Lyophilised polysaccharide solutions and gels incorporating the broad spectrum antimicrobial compound, chlorhexidine digluconate (CHD), have potential application as self-adhering, topical delivery systems for the prophylaxis and treatment of wound infections. It is desirable to sterilise these dosage forms but they do not possess suitable thermal properties to be sterilised by autoclaving or dry heat procedures. Ionising radiation may offer a solution hence 'antimicrobial wafers' fabricated from guar (GG), xanthan (XG), karaya (KAG), sodium alginate (SA) and a 50:50 blend of SA:KAG, were gamma-irradiated (25 and 40 kGy). Wafer sterility was qualitatively determined and validated for bacterial and fungal species. The rheological properties of gels reconstituted from irradiated discs ('wafers') were measured and compared with control samples (non-irradiated) to assess changes to the flow properties. Diffusion of CHD from the resultant gels and viscous solutions, and efficacy against Pseudomonas aeruginosa, was determined using a disc diffusion test and release studies conducted in a diffusion cell apparatus. Although there was no change to cast shape, the rheological properties were drastically depleted for all irradiated samples except XG which showed no effective change in consistency, yield stress or efficacy, from the non-irradiated control. SA and SA-KAG samples displayed 'anomalous' release according to Korsmeyer-Peppas.

Production and evaluation of an antimicrobial peptide-containing wafer formulation for topical application.

A targeted approach for direct topical antimicrobial delivery involving the formulation of impregnated freeze-dried wafers prepared from a natural polymer has been assessed to consider potential for treatment of wounded skin. The synthetic cationic antimicrobial peptides (CAPs) NP101 and NP108 were found to have modest in vitro activity against bacterial species commonly associated with wound infections. Minimum inhibitory concentration/minimum bactericidal concentrations against Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa were found to be 0.31 mg/ml for NP101 and 0.25-0.5 mg/ml for NP108. Rapid, substantial cytoplasmic potassium loss was induced by NP108 in E. coli, but not the other species. Through scanning electron microscopy, both CAPs were observed to alter cell morphology, prevent normal septation, promote cell aggregation and trigger release or formation of extracellular filaments. Wafers harbouring these agents displayed substantial antibacterial activity when assessed by standard diffusion assay. These data confirm that topical delivery of CAPs, through their incorporation within freeze-dried wafer formulations prepared from natural polymers, represents a potential viable approach for treating skin infection.

Lyophilised wafers as vehicles for the topical release of chlorhexidine digluconate--release kinetics and efficacy against Pseudomonas aeruginosa.

There is a requirement to deliver accurate amounts of broad spectrum antimicrobial compounds locally to exuding wounds. Varying amounts of exudate complicates this process by limiting the residence and therefore efficacy of active substances. Minimum bactericidal concentrations (MBC) of antimicrobials are necessary to suppress infection and lessen the chances of resistant strains of potentially pathogenic bacteria from prevailing. Polysaccharide wafers can adhere to exudating wound beds, absorbing fluids and forming highly viscous gels that remain in situ for prolonged periods of time to release sustained amounts of antimicrobial. In this study, five different formulations were produced containing the antimicrobial, chlorhexidine digluconate (CHD). Absorption of simulated wound fluid, resultant rheological properties of gels and efficacy against plated cultures of Pseudomonas aeruginosa were measured and compared. CHD reduced the 'water uptake' of wafers by 11-50% (w/w) and decreased the rheological consistency of non-SA containing gels by 10-65%. Release studies indicated that karaya wafers gave the highest sustained release of CHD, >60 µg/mL in 24 h, well in excess of the MBC for P. aeruginosa. Release kinetics indicated an anomalous diffusion mechanism according to Korsmeyer-Peppas, with diffusion exponents varying from 0.31 to 0.41 for most wafers except xanthan (0.65).

In vitro efficacy of antimicrobial wafers against methicillin-resistant Staphylococcus aureus.

BACKGROUND: Lyophilized wafers have been developed as vehicles for the storage and delivery of therapeutic compounds to exuding wounds. The primary objective of this study was to incorporate a selection of antimicrobial compounds in karaya wafers and measure their efficacy against methicillin-resistant Staphylococcus aureus. METHODS: Four antimicrobial compounds, including an antibiotic, were incorporated within karaya gels and freeze-dried to a shaped-disc form suitable for in vitro testing against methicillin-resistant S. aureus. Disc diffusion and Franz diffusion methods were used to quantify the utility and efficacy of these 'antimicrobial wafers'. Flow rheology and scanning electron microscopy were also used to aid gel and wafer characterization. RESULTS: Lyophilized wafers swelled in simulated wound fluid and released the contained compounds with mixed effect. Povidine-iodine and chlorhexidine were most effective in protein-free buffer while the action of neomycin sulfate was enhanced by the presence of bovine serum albumin. Silver sulfadiazine was the least effective overall.