Quaternary Ammonium Disinfectants: Current Practices and Future Perspective in Infection Control: Review Article

Hospital-acquired infections (HAIs) are one of the most tangled difficulties in advanced clinical practices. These infections lead to financial implications and have a significant impact on morbidity and mortality. It is very difficult to eradicate the HAIs however both disinfection and sterilization account for the best measure to control HAIs. Of all the disinfectants in use, one of the chemical disinfectants which seem to be user-friendly, non-corrosive, and used extensively are Quaternary ammonium compounds (QACs) based disinfectants. To improve the efficacy of these disinfectants and tackle the challenge of antimicrobial resistance (concerning QACs), from time to time newer QACs disinfectants were introduced which are termed as first, second, third, fourth, and fifth-generation QACs disinfectants. Manufacturers of these newer generations QACs disinfectants claim these compounds as high-level, broad-spectrum disinfectants while leading healthcare agencies like the Centre for Disease Control & Prevention (CDC) mention QACs as mild disinfectants and not sporicidal. Sadly, the antimicrobial efficacy of QACs has been largely assessed using old methods like phenol coefficient methods & suspension methods, and not using an internationally standardized method. These loopholes raise a lot of queries about the true efficacies of the QACs and thus, increase the chances of the development of resistant HAIs. Therefore, there is an urgent need for better and standardized methods to study the efficacy of different generation QACs. The present review discusses the status of currently available methods and gaps in the literature that would be useful to highlight the potential use of QACs for infection control and prevention in better ways.