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Pertinax

Chlorhexidine (CHX) is used as an antimicrobial and antifungal agent in a wide range of human and veterinary healthcare applications. It is effective against gram-positive and gram-negative bacteria, MRSA and E.coli, as well as yeasts and fungi. 

Pertinax is a slow-release technology that provides a continual release of CHX over an extended period. The duration of its effectiveness can be ‘tuned’ to clinical need, from days to weeks or even months. 

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History

The breakthrough that led to the development of Pertinax is the invention of a range of novel complex phosphate salts of CHX. These have tailored solubility and, used in conjunction with materials or as the active component of topical applications, ensure a CHX-rich environment is sustained for the required period of time. The duration of activity can be controlled by the selection of appropriate physical and formulation parameters to address the clinical need.

Dr Michele Barbour and her research group at the University of Bristol have been developing sustained efficacy antimicrobial materials for many years. As a result of this research, Pertinax Pharma Ltd was established in April 2015, to commercialise the many and diverse applications of this proprietary CHX technology. 

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Research & Development

Chlorhexidine

CHX is a broad-spectrum biocide. It owes its antibacterial and antifungal efficacy to membrane disruption. It is efficacious against gram-negative and gram-positive, as well as yeast, some bacterial spores and enveloped viruses. 

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Current usage and benefits

CHX has been used extensively in healthcare since the 1960s, usually as the soluble digluconate salt. It is used in oral rinses after oral surgery and for the treatment of gingivitis and mouth ulcers. CHX is also used in topical skin cleansing agents such as liquids, gels or sprays and in wipes, swabs or clothes for a diverse range of conditions in humans and animals. 

Pertinax is used in significantly lower concentrations to achieve better antimicrobial activity than is attainable using conventional CHX salts. This is because Pertinax is not rapidly lost to the local environment upon contact. Pertinax also has a low regulatory risk, which means clinical development is relatively rapid depending on the application. This is also straightforward to manufacture on a large scale, meaning that commercial margins are likely to be attractive even in low cost, price sensitive applications.

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Limitations of CHX

With all current CHX based products, the duration of antimicrobial activity is limited. The CHX may be delivered to the site of infection or prevention, but it is highly soluble and is rapidly removed by local fluids such as saliva, tissue fluid or sweat, as well as bathing or abrasion. Obtaining long-term local delivery of CHX is therefore an aspiration in many fields of healthcare. Its broad-spectrum efficacy means that if a CHX-rich environment could be maintained in an area at risk of infection, this could provide a potent protective effect. If applied to an area already colonised by pathogenic microbes, a sustained CHX supply could bring the infection under control as well as provide on-going protection against reinfection.

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CHX and Antimicrobial Resistance

Bacterial resistance to antibiotics is a matter of global concern. Many of our mainstream antibiotics are failing, as microbes evolve resistance to their specific modes of action. Biocides are considered to present lower risk of resistance, since their mode of action is non-specific compared with antibiotics and this genuine resistance is of lower likelihood. Furthermore, since Pertinax delivers its CHX payload as a steady and sustained rate, it can maintain the dose of antiseptic at a clinically optimal level for a sustained period, eliminating the risk of periods of sub-optimal antiseptic concentrations that can drive resistance under certain circumstances.