Abstract：
The prevention and management of ocular surface infections is still one of the great challenges for ophthalmologists. The spread of antimicrobial resistance makes it necessary to use antiseptic substances with a broad antimicrobial spectrum. Polyhexamethylene biguanide hydrochloride (Polyhexanide, PHMB) is a broad-spectrum antiseptic with excellent tolerance and a low-risk profile. Its physicochemical action on the phospholipid membrane and DNA replication or repair mechanism, prevents or impedes the development of resistant bacterial strains. PHMB revealed its effective against numerous organisms like viruses, Gram-negative and Gram-positive bacteria, and fungi. Polyhexanide is commonly used as preservative in commercially available disinfecting solutions for contact lens care and in ophthalmic formulations at different concentrations ranging from 1 µg/ml to 50 µg/ml. The administration of 0.02% (200 µg/ml) PHMB is often the first-line therapy of Acanthamoeba keratitis. However, to date, only one close-out randomized controlled study tested the efficacy of 0.02% PHMB in Acanthamoeba keratitis and a phase III study is still ongoing. This paper reviews the antiseptic agent PHMB, focusing on biochemical mechanisms, safety profile and applications in ophthalmology.
摘要：
眼表感染的预防和管理仍然是眼科医生面临的巨大挑战之一。抗菌素耐药性的传播使得有必要使用具有广谱抗菌的抗菌物质。聚六亚甲基双胍盐酸盐（聚己酰胺，PHMB）是一种广谱防腐剂，具有出色的耐受性和低风险特征。其物理化学作用于磷脂膜和DNA复制或修复机制，防止或阻碍耐药菌株的发展。PHMB揭示了它对许多生物如病毒的有效性，革兰氏阴性和革兰氏阳性细菌，和真菌。聚己酰胺通常在市售的用于隐形眼镜护理的消毒溶液中和在1μg/ml至50μg/ml的不同浓度的眼用制剂中用作防腐剂。0.02%（200μg/ml）PHMB的给药通常是棘阿米巴角膜炎的一线治疗。然而,到目前为止,只有一项结束的随机对照研究测试了0.02%PHMB治疗棘阿米巴角膜炎的疗效,一项III期研究仍在进行中.本文综述了防腐剂PHMB,专注于生化机制，安全概况和眼科应用。
