Pharmacotherapeutic group: Gynaecological anti-infective and antiseptic, Quinoline derivatives
ATC code: G01A C05
Dequalinium chloride is an anti-infective and antiseptic agent belonging to the class of quaternary ammonium compounds.
Mechanism of Action
Dequalinium chloride is a surface-active substance. The primary mechanism of action is an increase in bacterial cell permeability and the subsequent loss of enzyme activity, finally resulting in cell death.
Dequalinium chloride exhibits a rapid bactericidal activity.
Dequalinium chloride in vaginal tablets exerts its action locally within the vagina.
Pharmacokinetic/pharmacodynamics relationship
No major PK/PD determinant of efficacy has been established for Fluomizin. As the bactericidal effect of dequalinium chloride occurs within 30 to 60 minutes, the maximum local concentration within the first hour after application is considered crucial for the efficacy.
Mechanism(s) of resistance
The mechanisms resulting in the inherent resistance of some pathogens are not known. No mechanisms of acquired resistance have been observed thus far.
Breakpoints
No Breakpoints for dequalinium chloride are available by any recommending body and no relationship between minimal inhibitory concentrations and the clinical efficacy has been established. Thus, the information on susceptibility in the table below is descriptive and is based on the concentrations achievable in the vagina (see section 5.2) and respective MIC data of the pathogens.
The prevalence of acquired resistance may vary geographically and with time for selected species and local information on resistance is desirable, particularly when treating severe infections. As necessary, expert advice should be sought when the local prevalence of resistance is such that the utility of the agent in at least some types of infection is questionable.
Commonly susceptible species
Aerobic Gram-positive bacteria
Enterococcus faecalis
Lactobacillus
spp
.
Staphylococcus aureus
Streptococcus agalactiae
(Group B streptococci)
Streptococcus pyogenes
(Group A streptococci)
Aerobic Gram-negative bacteria
Enterobacter
spp
.
Escherichia coli
Klebsiella s
pp
.
Pseudomonas
spp
.
Serratia
spp.
Anaerobic bacteria
Atopobium
vaginae
Bacteroides spp.
Fusobacteria
Gardnerella vaginalis
Prevotella
spp
.
Peptostreptococci
Poryphyromonas
spp
Species for which acquired resistance may be a problem
None known
Inheritantly resistant organisms
Gram-negative bacteria
Proteus sp.
Chlamydia trachomatis
Other micro-organisms
Trichomonas vaginalis