General Properties and Mechanism of Antimicrobial Action
The pharmacological properties of aldehydes and alcohols are based on their ability to exert powerful microbicidal action. The destruction of microorganisms occurs via two consecutive stages:
- Profound dehydration of microbial cells.
- Irreversible coagulation of protoplasmic proteins.
As a result of these physicochemical processes, the cell loses viability and dies. The spectrum of antimicrobial activity covers a wide range of pathogens: bacteria (including vegetative forms and spores), fungi, and viruses.
Formaldehyde Solution and Antiperspirant Agents
Formaldehyde solution features not only a broad antimicrobial spectrum but also a powerful tanning (protein-crosslinking) effect on tissues. This property forms the basis of its use in hyperhidrosis management: the tanning effect damages sweat glands, reliably suppressing sweat secretion.
In medical practice, formaldehyde is used as a disinfectant and deodorant for instruments and patient care items, as well as in gynecology for diluted douches. Specialized topical preparations such as Formagel and Formidron have been developed for treating excessive sweating.
Hexamethylenetetramine (Methenamine, Urotropin)
This substance is a classic prodrug. Its distinctive feature is that it exhibits antiseptic properties exclusively in an acidic environment, such as during inflammation when the urine pH shifts to the acidic side.
Bioactivation occurs in the urine, where the compound breaks down to release active formaldehyde, which destroys the pathogenic flora. The effect can be either bactericidal or bacteriostatic depending on the concentration. The main indications relate to kidney and urinary tract infections, such as cystitis, pyelitis, and urethritis. Today, methenamine is rarely used due to the availability of more effective alternatives.
Policresulen and Its Effects
Policresulen is a copolymer of hydroxymethylbenzenesulfonic acid and formaldehyde. It exhibits a wide range of pharmacological effects, including antimicrobial (bactericidal, fungicidal, antiprotozoal), astringent, cauterizing, keratolytic, and hemostatic actions.
The drug is used exclusively topically across several medical specialties:
- Gynecology: cervical and vaginal erosions, vulvovaginitis, urethral papillomas.
- Surgery and dermatology: slow-healing wounds, leg ulcers, third-degree burns, condylomata acuminata.
- Dentistry: inflammation of the oral mucosa, aphthae, and cessation of bleeding after minor surgical procedures.