The antiseptic Miramistin: a review of its comparative in vitro and clinical activity

FEMS Microbiol Rev. 2020 Jul 1;44(4):399-417. doi: 10.1093/femsre/fuaa012.


Miramistin is a topical antiseptic with broad antimicrobial action, including activity against biofilms and a clinical profile showing good tolerability. Miramistin was developed within a framework of the Soviet Union Cold War Space Program. It is available for clinical use in several prior Soviet bloc countries, but barely known outside of these countries and there is almost no mention of miramistin in the English literature. However, considering emerging antimicrobial resistance, the significant potential of miramistin justifies its re-evaluation for use in other geographical areas and conditions. The review consists of two parts: (i) a review of the existing literature on miramistin in English, Russian and Ukrainian languages; (ii) a summary of most commonly used antiseptics as comparators of miramistin. The oral LD50 was 1200 mg/kg, 1000 mg/kg and 100 g/L in rats, mice and fish, respectively. Based on the results of the review, we suggest possible applications of miramistin and potential benefits over currently used agents. Miramistin offers a novel, low toxicity antiseptic with many potential clinical uses that need better study which could address some of the negative impact of antimicrobial, antiseptic and disinfectant resistance.

Keywords: Candida; MRSA; antimicrobial resistance; miramistin; toxicity.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Animals
  • Anti-Infective Agents / pharmacology
  • Anti-Infective Agents / toxicity
  • Anti-Infective Agents, Local / pharmacology
  • Anti-Infective Agents, Local / toxicity
  • Benzalkonium Compounds* / history
  • Benzalkonium Compounds* / pharmacology
  • Benzalkonium Compounds* / standards
  • Benzalkonium Compounds* / toxicity
  • Cell Survival / drug effects
  • History, 20th Century
  • Lethal Dose 50
  • Russia
  • USSR


  • Anti-Infective Agents
  • Anti-Infective Agents, Local
  • Benzalkonium Compounds
  • miramistin