Ethan Sawyer, Evan Johnson, Lester Hubble, Caleb Freeman, Paul Watson
Background: The aim of this study was to determine the duration of efficacy of 0.13% benzalkonium chloride (BAC), 4% chlorhexidine and 70% Ethanol in decreasing MRSA and Cutibacterium acnes (C. acnes) colonization and regrowth when plated on culture media. Specifically, the study was aimed at determining how long the antiseptics can be applied preoperatively while remaining effective.
Methods: Sterile discs saturated with either 0.13% BAC, 4% chlorhexidine, or 70% ethanol were placed on 5% sheep blood agar plates cultured with either MRSA or C. acnes. The clearance of bacteria surrounding the discs was measured at 24 hour increments for a total of 120 hours to determine the original zone of inhibition (ZOI) as well as any bacterial regrowth.
Result: 4% chlorhexidine and 0.13% BAC produced a consistent ZOI that increased in size and that did not permit any significant regrowth of the bacteria over 120 hours. 70% ethanol did not show any ZOI for either MRSA or C. acnes at any time point.
Conclusion: The results of this study demonstrate the potential of using BAC for preoperative shoulder preparation given the duration of effect. Further study is warranted to determine the in vivo effectiveness of this formulation of BAC.
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