Antiseptic skin and mucosal decontamination
Reduction of microbial load on skin and mucosa before invasive procedures, in wound care and for routine hand hygiene in healthcare.
4 drugs
Also known as: Skin disinfection, Wound decontamination
Drugs used for this condition
- AChlorhexidineFirst line · Biguanide antiseptic for skin and mucous membranesFirst-line antiseptic for preoperative skin and hand decontamination. 2% chlorhexidine in 70% isopropanol reduces SSI risk after clean surgery vs povidone-iodine. AEMPS and SEIMC recommend it as standard for central venous catheter care.
- BEthanolFirst line · Skin antiseptic and disinfectantAlcohol is the basic antiseptic for intact skin: preparation before an injection, before blood sampling, hand disinfection. The AEMPS ficha técnica frames the indication in one line – a skin antiseptic, applied directly to the area and left to act for two minutes before a procedure. The 2009 WHO hand hygiene guidelines place alcohol-based products at the core of hand hygiene in healthcare: they act faster than washing with soap and the skin tolerates them better. There are two practical limits. Alcohol is flammable, and before any procedure involving a flame or electrocautery it must dry completely. And it does not work on spores, so during Clostridioides difficile outbreaks hands are washed with soap and water. Frequent use dries the skin and causes contact dermatitis.
- BIsopropanolFirst line · Skin antiseptic and disinfectantIsopropanol with chlorhexidine is the standard for preparing skin before an invasive procedure: catheter insertion, venipuncture, biopsy, surgery. The AEMPS ficha técnica even describes the choice of applicator: 1 ml covers an 8 by 10 cm area for a peripheral cannula, venipuncture and a simple biopsy, with larger applicators for bigger fields. The point of the pair is that the alcohol acts instantly while chlorhexidine stays on the skin and keeps working for hours. The 2009 WHO hand hygiene guidelines describe the same logic for healthcare workers' hands. Two warnings matter more than the rest: the solution is flammable and must dry completely before an electrosurgical unit or laser is used, and in preterm infants, especially before 32 weeks and in the first two weeks of life, alcohol solutions cause chemical burns.
- BPovidone-iodineFirst line · Broad-spectrum antiseptic, iodine productPovidone-iodine is the main household antiseptic of the Spanish pharmacy: Betadine sits in almost every first aid box. The AEMPS ficha técnica frames the indication as a general skin antiseptic for small wounds, superficial cuts, minor burns and grazes: the area is washed and dried, then a small amount is applied 2 to 3 times a day. The spectrum is broad – bacteria, fungi, viruses and spores – and resistance does not arise. The limits matter more than the promises: the ficha asks to avoid regular and prolonged use, especially with burns over 20 percent of body surface, large open wounds, hepatic and renal failure, thyroid disease and lithium treatment. The product is contraindicated in newborns from 0 to 1 month.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit