In July 2015,
olanexidine gluconate, a biguanide compound with remarkable
antibacterial activity, was approved by the Pharmaceuticals and
Medical Devices Agency (PMDA) of Japan for skin antisepsis
at surgical sites. The drug was developed and marketed by
Otsuka Pharmaceutical in Japan and is available as topical
solution (1.5%). Olanexidine gluconate exhibited efficacy
against a wide range of bacterial strains, especially Grampositive
bacteria. In vitro experiments exploring its mechanism
of action indicated that olanexidine interacts with bacterial
surface molecules (such as lipopolysaccharides and lipoteichoic
acid), disrupting the cell membranes of liposomes. These
models suggest that the drug permeates the membranes of both
Escherichia coli and Staphylococcus aureus and denatures proteins
at relatively high concentrations (>160 g/mL).
