Many mass-marketed inhaler and nasal spray formulations contain benzalkonium chloride as a preservative, despite substantial evidence that it can adversely affect ciliary motion, mucociliary transport, nasal mucosal histology, human neutrophil function, and leukocyte response to local inflammation.
42.
In 2011, a large clinical trial designed to evaluate the efficacy of hand sanitizers based on different active ingredients in preventing virus transmission amongst schoolchildren was re-designed to exclude sanitizers based on benzalkonium chloride due to safety concerns.
43.
Within the United States, products such as Humco Mercuroclear play on the brand recognition history of Mercurochrome, but substitute other ingredients with similar properties ( Mercuroclear : " Aqueous solution of benzalkonium chloride and lidocaine hydrochloride " ).
44.
More recently, formulations that use benzalkonium chloride have been shown to have persistent and cumulative antimicrobial activity after application, unlike alcohol, which has been shown to decrease in efficacy after repeated use, probably due to progressive adverse skin reactions.
45.
The study, which was undertaken and reported by a leading US developer, manufacturer and marketer of topical antimicrobial pharmaceuticals based on quaternary ammonium compounds, found that their own benzalkonium chloride-based sanitizer performed better than alcohol-based hand sanitizer after repeated use.
46.
A biocide treatment was attempted, involving benzalkonium chloride, miristalkonium chloride, and 2-octyl-2H-isothiazole-3-one, which resulted in a net decrease of fifty percent of the fungus in the caves, but it was noted that those left had a significant increase in their diversity.
47.
The pharmaceutical drug "'Bilina "'is a combination of Levocabastine, benzalkonium chloride, and other components and is typically used in a 0.5 mg / ml suspension as eye-drops, dispensed in 4ml bottles for the treatment of allergic conjunctivitis or similar allergic ocular conditions.
48.
Advancements in the quality and efficacy of benzalkonium chloride in current non-alcohol hand sanitizers has addressed the CDC concerns regarding gram negative bacteria, with the leading products being equal if not more effective against gram negative, particularly New Delhi metallo-beta-lactamase 1 and other antibiotic resistant bacteria.
49.
Concentrated solutions are toxic to humans, causing corrosion / irritation to the skin and mucosa, and death if taken internally in sufficient volumes . 0.1 % is the maximum concentration of benzalkonium chloride that does not produce primary irritation on intact skin or act as a sensitizer.
