Table 1

Advantages and disadvantages of commonly used high-level disinfectants

High–level disinfectantAdvantage(s) (reference[s])Disadvantage(s) (reference[s])
GlutaraldehydeExcellent biocidal properties (5, 33 35)Slow action against mycobacteria (35, 38)
Many studies publishedIrritant to the respiratory tract, eyes, and skin; development of allergic reactions, contact dermatitis, asthma, acute colitis (36, 37)
Does not damage endoscopes and processing equipment; noncorrosive to metal (5, 33)Development of biocide resistance (39 42)
Relatively inexpensive (5)Coagulation and fixation of proteins (5)
ortho-PhthalaldehydeHigh biocidal activity (inclusive of mycobacteria) (5, 44)Slow action against bacterial spores (5)
Does not damage endoscopes and processing equipmentStaining of the skin, clothing, instruments (46)
Irritation of the respiratory tract and eyes; development of “anaphylaxis-like” reactions after repeated use (5, 36, 45)
Expensive
Peracetic acidExcellent and fast biocidal activity at low concentrations (5, 7)Irritant to the respiratory tract and eyes (5, 7, 36)
Can be used at low temperatures (5, 7)Corrosive action depending on the pH value and concn (7)
No development of resistance reportedLimited efficacy in biofilm removal and in killing bacteria within the biofilm (47 49)
Electrolyzed acid and superoxidized waterExcellent and fast biocidal activity (15)Reduced efficacy in the presence of organic soil after inappropriate cleaning (50)
Nontoxic to biological tissues; nonirritant to the respiratory tract, eyes, and skin (15)
Relatively inexpensive