b'PHMB is Potent against Gram Positive & Gram Negative BacteriaAverage of 6.13 Log Reduction of CFUs10 Conclusion from the authors: Prontosan (PHMB +Betaine) has high bactericidal activityactivity against the studied multidrug-resistantpathogens. Furthermore, this bactericidal activity occurs rapidly (1 min), within a much shorter period of time than that recommended by the manufacturer.PHMB is Safer & More Effective than Other AntimicrobialsComparison to CHG, PVP-I & Topical Antibiotics PHMB has greater antimicrobial efficacy than chlorhexidine under clean and dirty conditions.11PHMB-Betaine solution has significantly greater activity than 2% Chlorhexidine against 24 hr, 48 hr, and 7 day biofilms.12 With and without organic bioburden, PHMB is more effective than CHG.13 Severe reactions observed after short term application of chlorhexidine digluconate.9Because of tissue toxicity, in some countries, CHG based products are no longer authorized18PHMB exceeds efficacy of PVP-I in situations with high blood load11 PHMB is more effective than povidone-iodine.15In vitro data show superiority of PHMB over PVP-I against broad microbial spectrum.14The WHO does not recommend topical use of, or rinsing with antibiotics.9In comparison to modern antiseptics, topical antibiotics are considered obsolete.9Agent IntracellularDevelopmentSelectiveWound Healing CartilageSensitization Systemic RisksKilling of ResistanceAntisepticTolerancePHMB Yes No Effect Positive Effect 0.005% No No+OCTENIDINE ? No No Inhibition No No NoPVP-I Yes No Partial Inhibition Yes Yes YesHYPOCHLORITE ? No + ? No NoACETIC ACID ? No 0.15% Positive? No NoeffectCHG ? Yes No Inhibition ? Yes PossiblySILVER ION ? Yes Inhibition ? No YesTRICLOSAN ? Yes No Inhibition ? Yes YesAionX 45'