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Synthetic Antiseptics

For medical students2 min readUpdated 2026-10-10

Synthetic antiseptics are a chemically diverse group of antimicrobial agents. They are primarily used for topical treatment of infectious and inflammatory conditions in otolaryngology, dentistry, gynecology, and ophthalmology.

Dosage FormsTablets, lozenges, aerosols, gels, solutions, and eye drops.

Spectrum of ActivityBacteria, fungi, viruses, protozoa (*Trichomonas*), and chlamydia.

Sites of ApplicationOral cavity, pharynx, respiratory tract, ocular mucosa, and vaginal mucosa.

Chemical NatureIndazole derivatives, biguanide derivatives, and other synthetic compounds.

Drugs for Oral and Respiratory Tract Infections

In dental and ENT practice, topical agents formulated as lozenges or sublingual tablets are widely used. They ensure sanitation of the infection focus in tonsillitis, pharyngitis, laryngitis, and stomatitis.

Ambazone monohydrate. Exhibits a pronounced bacteriostatic effect. Its broad activity spectrum covers both gram-negative flora and gram-positive microorganisms, including Streptococcus haemolyticus, Streptococcus viridans, and Pneumococcus. In addition to treating inflammation (including gingivitis), the drug is prescribed for the prevention of perioperative complications—for example, following tooth extraction or surgical tonsillectomy.
Acetylaminonitropropoxybenzene. Available as lozenges and used for treating inflammatory processes in the respiratory tract (laryngitis, tonsillitis, pharyngitis).
Grammidin. A combination product containing the synthetic antiseptic cetylpyridinium chloride and the antibiotic gramicidin S. The drug not only destroys microbes and reduces inflammation, but also induces hypersalivation. Increased salivation helps mechanically cleanse the mucous membranes of the pharynx and oral cavity.
Amylmetacresol / Dichlorobenzyl alcohol. Effective lozenges acting on gram-positive and gram-negative flora while providing symptomatic relief: soothing throat irritation and relieving pain in infectious and inflammatory oropharyngeal diseases.

Broad-Spectrum Universal Antiseptics

Certain synthetic drugs possess an expanded spectrum of activity and are available in various dosage forms (gels, aerosols, douching and mouthwash solutions, tablets), allowing their use not only in ENT and dentistry but also in gynecology.

Benzydamine. Chemically an indazole derivative. The drug is distinguished by a unique triad of pharmacological effects: antiseptic, anti-inflammatory, and local anesthetic activity. Benzydamine is lethal to bacteria (including Gardnerella vaginalis), trichomonads, and fungi. In gynecology, its solutions are used to treat vaginitis of trichomonal and fungal etiology, while in dentistry and otolaryngology, they manage infectious-inflammatory processes (stomatitis, tonsillitis, pharyngitis).
Hexetidine. The mechanism of action is based on competitive antagonism with thiamine. By displacing thiamine, hexetidine blocks oxidative reactions and disrupts bacterial cell metabolism. It demonstrates high antibacterial activity (especially against gram-positive flora, Proteus, and Pseudomonas aeruginosa) and exhibits antifungal properties, destroying Candida species.

Application in Ophthalmology

Synthetic antiseptics are also used to treat ocular infections. A prominent representative of this group is picloxydine.

Structurally, picloxydine belongs to the biguanide derivatives. It is available as eye drops and is prescribed for patients with infectious conjunctivitis and keratoconjunctivitis.

Its main advantage is the exceptionally broad spectrum of antimicrobial activity. Picloxydine destroys:

Gram-positive bacteria (Streptococcus, Staphylococcus).
Gram-negative bacteria (Shigella, Klebsiella, Escherichia coli, Proteus, Chlamydia).
Viruses and fungi.

Particularly valuable is its high efficacy in treating ocular chlamydial infections, which few topical antiseptics can achieve.

Mnemonic

The triad of benzydamine effects can be easily remembered by the acronym A-P-M: Antiseptic, Panti-inflammatory (Anti-inflammatory), Metabolically/Local anesthetic (Local anesthetic action).

Frequently asked questions

What chemical classes of synthetic antiseptics are used in clinical practice?

Synthetic derivatives of various chemical groups are used in clinical practice. The main classes include:

8-Hydroxyquinoline derivatives — quinosol, nitroxoline.
4-Quinolone derivatives — oxolinic acid.
Quinoxaline derivatives — dioxidine.
Nitrofuran derivatives — nitrofurazone, furazolidone.
Phenol derivatives — resorcinol, tricresol, tars.
Indazole derivatives — benzydamine.
Biguanide derivatives — picloxydine.
Sulfonamide amide derivatives — sulfonamides.

Which drugs belong to the nitrofuran derivative group?

The nitrofuran derivative group includes the following synthetic antimicrobial agents containing a furan ring:

Nitrofurazone — the most common antiseptic of this group.
Nitrofurantoin — a representative of the class.
Furazolidone — a representative of the class.
Furazidin — a representative of the class.
Nifuroxazide — a representative of the class.

How does hexetidine work at the cellular level?

It acts as a thiamine antagonist. The drug disrupts oxidative reactions, leading to impaired bacterial metabolism and cell death.

Why is an antiseptic added to Grammidin if it already contains an antibiotic?

The combination of cetylpyridinium chloride and gramicidin S provides a comprehensive antimicrobial effect and reduces inflammation. Additionally, the drug stimulates hypersalivation, which promotes mechanical cleansing of the oral cavity and pharynx.

Which synthetic antiseptic is effective against chlamydial eye infections?

Picloxydine. It is available as eye drops and is active not only against typical bacteria, but also against chlamydia, viruses, and fungi.

Go deeper

Mechanism of the bacteriostatic action of ambazone monohydrate.
Features of benzydamine application in the treatment of fungal and trichomonal vaginitis.
The role of hypersalivation in the therapy of infectious and inflammatory oropharyngeal diseases.
Comparative activity profile of hexetidine against Pseudomonas aeruginosa and Proteus.
Biguanide derivatives: chemical structure and relationship with antimicrobial activity using picloxydine as an example.