Background of the Formula:
Polyhexamethylene biguanide (PHMB) concentrate is sold as a white to pale yellow solid or as an aqueous solution and used as a preservative or disinfectant. PHMB is an effective public health biocide registered for numerous applications by the U.S. EPA under the Federal Insecticide, Fungicide, and Rodenticide Act, and supported under the Biocidal Products Directive in Europe.
PHMB is historically used as a sanitizer or preservative to kill bacteria and viruses and to control algae in a wide range of applications globally.
As a sanitizer, PHMB is used to preserve wet wipes; to control odor in textiles; to prevent microbial contamination in wound irrigation and sterile dressings; to disinfect medical/dental utensil and trays, farm equipment, animal drinking water, and hard surfaces for food handling institutions and hospitals; and to deodorize vacuums and toilets. PHMB is used in antimicrobial hand washes and rubs and air filter treatments as an alternative to ozone. PHMB is also used as an active ingredient for recreational water treatment, as a chlorine-free polymeric sanitizer, which is effective against a wide variety of microorganisms. As a preservative, PHMB is used in cosmetics, personal care products, fabric softeners, contact lens solutions, hand washes, and more.
In addition, a solution of PHMB has been shown to be highly effect in reducing surgical site infections, and, in particular, reducing the incidence of methicillin resistant staphylococcus infections.
In the American J Infect Control. 2008 Nov;36(9):651-5. doi: 10.1016/j.ajic.2007.12.005. Epub 2008 Oct 3. titled
“Impact of an antimicrobial-impregnated gauze dressing on surgical site infections including methicillin-resistant Staphylococcus aureus infections. Authored by Mueller SW, and Krebsbach LE. From the Epidemiology Department, BryanLGH Medical Center, Lincoln, Nebraska, USA. firstname.lastname@example.org
The following was noted:
Surgical site infections (SSIs) are a common complication of surgery. Methicillin-resistant Staphylococcus aureus (MRSA) is a particularly troublesome infectious agent in this setting. SSIs contribute to increased morbidity and mortality, as well as increasing length of hospital stay and costs.
Sterile plain gauze dressings were replaced institution-wide by a comparable sterile antimicrobial gauze dressing (AMD) impregnated with 0.2% polyhexamethylene biguanide. SSIs, and specifically MRSA-SSIs, were tracked for the 11-month periods before and after the dressing switch, using Centers for Disease Control and Prevention criteria.
Before the introduction of AMD, 101 SSIs occurred after 9372 surgical procedures (1.08%), 20 of which were identified as MRSA (0.21%). After introduction of AMD, 84 SSIs occurred after 10,202 surgical procedures (0.82%), representing a rate reduction of 24.07% (P = .035), with 11 identified as MRSA (0.11%), representing a reduction of 47.62% (P = .047). This reduction in SSIs represents an annual cost savings to the institution of $508,605.
A significant reduction in SSIs, and specifically MRSA-SSIs, resulted from a simple change from plain sterile gauze to a sterile comparable antimicrobial dressing. This change reduced morbidity and possibly mortality after surgery, shortened hospital stays, and reduced the costs of postsurgical care.
We have concluded that PHMB is an extremely effective biocidal against a wide variety of bacteria including MRSA.