Triple dye
Triple dye is a combination of brilliant green (0.2%), proflavine hemisulfate (0.1%) and gentian violet (0.1%). It is bacteriostatic against gram-positive bacteria but less effective against gram-negative bacteria. It is fungicidal but has weak virucidal activity and is not sporicidal. It colours the skin bright purple. Triple dye has the advantage of a prolonged antibacterial effect after a single application.
In several studies, triple dye was found to be more effective in reducing umbilical colonization by staphylococcal and streptococcal organisms in hospital nurseries than alcohol,91 hexachlorophene,92 bacitracin ointment93 and povidone-iodine.94 It is effective even if applied only once. Triple dye has also been shown to reduce colonization by methicillin-resistant S. aureus although it could not totally eradicate the organism.95
However, triple dye is not effective against group B haemolytic streptococcal organisms; it may in fact promote colonization from this organism, as well as from gram-negative organisms.96,97 Triple dye may increase cord separation time.81, 98 Crystal violet, one of the components of triple dye, has been associated with necrotic skin reactions in adults and babies.99 Sensitization to brilliant green, another component of triple dye, has been reported.100