| Summary: | In recent years, a rise in the number of contact lens users in the UK and worldwide coincided with an increased incidence of microbial keratitis. The aim of this study was to investigate the antimicrobial activities of polyhexamethylene guanidine (PHMG), polyaminopropyl biguanide (PAPB), and guazatine in comparison to the common contact lens disinfectant constituent, polyhexamethylene biguanide (PHMB). The study investigated these compounds against a broad range of organisms, including <i>Acanthamoeba castellanii</i>, <i>Acanthamoeba polyphaga</i>, <i>Staphylococcus aureus</i>, <i>Pseudomonas aeruginosa,</i> and <i>Candida albicans</i>. This study demonstrated that PHMG, PAPB, and guazatine are equal in activity to PHMB against <i>Acanthamoeba</i> trophozoites and cysts. PHMG and PAPB are also equal in activity to PHMB against <i>S. aureus</i> and <i>P. aeruginosa</i>, whereas PHMG shows significantly better activity than PHMB against <i>C. albicans</i> (<i>p</i> < 0.001). To our knowledge, this is the first study to demonstrate the effectiveness of PHMB, PHMG, PAPB, and guazatine against <i>Acanthamoeba</i> and other ocular pathogens. As alternatives to PHMB, these compounds warrant further investigation for inclusion in contact lens solutions and for the treatment of keratitis.
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