Effect of octenidine dihydrochloride on viability of protoscoleces in hepatic and pulmonary hydatid diseases

Background: Use of effective scolicidal agents during puncture, aspiration or injection of a scolicidal agent and reaspiration (PAIR) and surgery for hydatid cysts are essential to reduce the recurrence rate. In this in vitro study, we tried to determine the scolicidal property of a new agent, octenidine dihydrochloride, and of various agents in different concentrations and exposure times. Material and Methods: Echinococcus granulosus protoscoleces were obtained from six patients with liver (n=3) and lung (n=3) hydatid cysts. Various concentrations of octenidine dihydrochloride (0.1%, 0.01% and 0.001% diluted form), poviclone iodine (10%, 1 % and 0. 1 % diluted) and 20% saline were used in this study. Viability of protoscoleces was determined with dye-uptake (0. 1 % eosin) and flame cell activity. Results: Octenidine dihydrochloride 0. 1% had strong scolicidal effect in 15 min and octenidine dihydrochloride 0.01% in 30 min. Sixty percent of protoscoleces lost viability at 5 min with octenidine dihydrochloride 0.1%. Viability ratio decreased to 20% at 10 min, and all of them died at 15 min. Povidone iodine 10% and I% had strong scolicidal effects after 15- and 30 min of exposure, respectively. Saline 20% killed all the protoscoleces in 30-min exposure. Conclusion: Because of the rapid and strong scolocidal effectiveness of octenidine dilhydrochloride on protoscoleces, it may be used as a scolocidal agent during both perioperative and in the PAIR method.