Safety, acceptability and antimicrobial activity of Octenidine on the skin microbiome of neonates

Background: Neonates are more prone to skin injuries and infections, warranting utmost care of their skin and appropriate antisepsis. Various antiseptics are used depending on local practices, associated with local effects on the neonatal skin and some with systemic effects. We tested one such compound, octenidine, already used in adults with a high margin of safety and efficacy but with a paucity of data in neonates.Methods: A pilot trial was conducted to compare octenidine with sterile water from randomization to discharge. The acceptability of octenidine was assessed with clinical parameters and skin scores in 60 neonates and a nursing survey conducted online. Skin microbiome was assessed at two sites (axilla and groin) at 48 hours of life after randomization for 21 neonates (72 samples) by using 16S rRNA approach.Results: Alpha and beta diversity matrices showed significant difference between the axilla and groin region. Shannon diversity measure indicated an increase in the diversity after usage of octenidine wipes and decrease in diversity after use of sterile water wipes.Conclusion: Our observations are limited by small sampling size, multiple sub-groups hence we recommend the need for a large trial to study the effect of octenidine on neonatal sepsis which can be lifesaving