Agents 

Users

Advantages

Disadvantages

Activities

Alcohols
(60-90%)

Low and intermediate level disinfection. Useful on small surfaces, e.g., stethoscopes. Also used a skin antiseptic.

Fasting acting

No residue

No staining

Evaporates quickly and activity ceases.

Volatile, flammable. Inactivated by organic matter. May harden rubber of cause glue to deteriorate.

Active against lipophilic, enveloped viruses, some bacteria including TB. Not active against hydrophilic viruses or spores.

Chlorines

(bleaching compounds including sodium hypochlorite and sodium dichloroiso-cyanurate)

(100-1000 ppm free chlorine)

Low and intermediate level disinfection. Used on hydrotherapy tanks, swimming pools, environment surfaces. Useful in home health as readily available in the market place. Useful for surface disinfection after clean-up if blood and body fluids.

Low cost, fast acting. Readily available in most settings. Available as liquid, tablets or powders.

Corrosive to metals. Inactivated by organic material thus cleaning must be done first. Irritating to skin and mucous membranes. Will evaporate if left uncovered.

Loses potency when exposed to light. Unstable when diluted with shortened shelf life.

Active against lipophilic, enveloped and some hydrophilic viruses and most bacteria including TB. Must be in contact at least 10-15 minutes.

Able to be sporicdal but not widely used for this purpose as not always reliable.

Store in opaque container.

Ethylene oxide (EO)

Gas sterilisation for heat and moisture sensitive devices.

Sterilant for heat or pressure-sensitive equipment.

Slow acting. Equipment must be aerated afterwards for 12 hours or according to manufacturer's instructions. Newer models allow for aeration of equipment within chamber. For older models, removal of equipment to a purpose-built aeration chamber may be done. Must be properly vented to avoid exposure.

Flammable, explosive. Probable carcinogen. Chlora-fluro deplete the ozone layer and are banned in many countries.

Destroys all microbial life with the exception of prions.

Formaldehydes

Limited use but occasionally used to re-process haemodialysers. Gaseous form used to decontaminate laboratory. Used as a tissue fixative for pathology lab.

Active in presence of organic matter. May be used as a cold sterilant.

Carcinogenic, toxic, strong irritant. Pungent odour. Very slow acting.

Active against all viruses, bacteria, but not against prions.

Variable sporicidal activity.

Glutaraldehyde

High-level disinfectant used for re-processing endoscopes, etc, that do not penetrate skin or mucous membrane and are unable to withstand high temperature or pressure. May be used as a cold sterilant taking 6 to 10 hours.

Allows rapid turn-around of items where ethylene oxide is too slow. Safe for most instruments and equipment.

Irritating to skin and respiratory tract. May cause reactions with sensitization. Items must be thoroughly pre-cleaned first. Takes about 10 hours to achieve sterilisation.

Active against all viruses, vegetative bacteria and fungi. Sporicidal from 6 to 10 hours exposure.

Hydrogen peroxide

3% as a low-level disinfectant. Useful as a cleaning agent. 6% as an intermediate level disinfectant. Used for foot care equipment, soft contact lenses. Combined with hydrogen peroxide, peracetic acid acts synergistically as cold sterilizer at 200 ° C in three hours or to achieve high-level disinfection in 15 minutes.

Strong oxidant.

Fast acting.

Breaks down into water and oxygen.

May be corrosive to aluminum, brass, copper, zinc aluminum.

Active against lipophilic enveloped viruses and some bacteria. Not active against hydrophilic viruses or spores at these concentrations unless combined with peracetic acid.

Iodophors

(30-50 ppm free iodine)

Low-level disinfectant for the environment. Intermediate level disinfectant for hydrotherapy tanks. Also available as a skin antiseptic in appropriate formulation.

Rapid action.

Relatively free of toxicity or irritancy.

Disinfectant formulation may burn tissue. May stain some fabrics. May be corrosive to metal. Inactivated by organic matter.

Active against most bacteria (less so against TB) both lipophilic and hydrophilic viruses. Not active against spores.

Orthophthalal-

dehyde

High level disinfectant used for reprocessing endoscopes, etc., that do not transect skin or mucous membrane and are unable to withstand high temperature or pressure.

Allows rapid turn- around of items where ethylene oxide is too slow. Safe for most instruments and equipment.

Irritating to respiratory tract and aggravates pre-existing chest conditions. Irritating to eyes, stains skin. May cause dermatitis with repeated exposure.

Active against all viruses, vegetative bacteria including spores and fungi.

Liquid peracetic acid

(Steris System 1)

Liquid sterilant for heat and pressure sensitive equipment when used in specially-designed

sterilisers. Also see hydrogen peroxide.

Breaks down to water, oxygen, acetic acid, hydrogen peroxide. Rapid action at low temperature.

Active in presence of organic matter.

Wraps not used.

May be corrosive.

Unstable when diluted.

May be irritating to skin, conjunctivae and mucous membranes.

Sterilant when used according to manufacturer's instructions. Biological indicator is b acillus stearothermophilus .

Hydrogen gas and plasma system (Sterrad)

Sterilant for stainless steel surgical instruments without lumens or hinges on some models of steriliser or with lumens that fit defined and frequently changed criteria. Check for current recommendations. Sterilant for both metallic and non-metallic devices. Lumens smaller than 6 mm can not be processed.

Aeration not required. Items may be used immediately after processing or stored for later use.

Not useful for dead-end lumens, paper, cellulose type materials, powders or liquids or certain lumen lengths and diameters.

Sterilant for items designated by manufacturer. Biological indicator is Bacillis atrophaeus . Also chemical indicator is integrated into package label.

Peracetic acid and gas plasma system (Plazlyte) (no longer sold but still in use)

Sterilant for stainless steel surgical instruments without lumens or hinges.

Aeration not required.

Outside vent required. Not suitable for implantable devices and bone tissue.

Sterilant for selected instruments without lumens or hinges. Biological indicators include circulens.

Phenolics

(usually 2%)

Low to intermediate disinfectant used mainly on environmental surfaces and equipment.

Leaves residual film - when wet is reactivated. Can be part of cleaning/disinfecting process if combined with appropriate detergent.

Not to be used in nurseries or food preparation areas. May be absorbed through skin and by rubber. Some surfaces may feel sticky with repetitive use.

Active against most bacteria, but less active against viruses. Active against lipophilic viruses but not against hydrophilic viruses.

Quaternary ammonium compounds (0.4 – 1.6%) (seven generations)

Low to intermediate level disinfectant used mainly on environmental surfaces and equipment.

Has good detergent properties. Usually non-irritating.

Has relatively narrow microbiocidal spectrum, but range of activity can be expanded with a tincture solution.

Active against some bacteria and lipophilic enveloped viruses. Not active against TB.