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Romanian Journal of Ophthalmology 2021Endophthalmitis remains a serious complication following intraocular procedures. Preoperative prophylactic measures for endophthalmitis decrease the morbidity associated... (Review)
Review
Endophthalmitis remains a serious complication following intraocular procedures. Preoperative prophylactic measures for endophthalmitis decrease the morbidity associated with this disease and represent a standard of care prior to ophthalmic surgery. The literature supports as measures for ocular antisepsis: povidone-iodine solution for ocular surface preparation, chlorhexidine in patients with iodine allergy and application of topical antibiotics. Povidone-iodine is regarded as the most effective antiseptic associated with significant reduction in ocular surface bacterial counts. Currently, the recommended preoperative management is the application of 5% povidone-iodine solution in the conjunctival fornix, prior to surgery. This paper reviews the preoperative measures for ocular antisepsis, used in order to decrease the risk of culture-proven endophthalmitis.
Topics: Anti-Infective Agents, Local; Antisepsis; Conjunctiva; Endophthalmitis; Humans; Povidone-Iodine
PubMed: 34179575
DOI: 10.22336/rjo.2021.25 -
Survey of Ophthalmology 2024Polyvinyl pyrrolidone or povidone-iodine (PVP-I) is a water-soluble complex formed by the combination of iodine and a water-soluble polymer, polyvinyl pyrrolidone. This... (Review)
Review
Polyvinyl pyrrolidone or povidone-iodine (PVP-I) is a water-soluble complex formed by the combination of iodine and a water-soluble polymer, polyvinyl pyrrolidone. This complex exerts bactericidal, fungicidal, and virucidal action by gradually releasing free iodine at the site of application to react with pathogens. In ophthalmology, PVP-I is used as a disinfectant and antiseptic agent for preoperative preparation of the skin and mucous membranes and for treating contaminated wounds. PVP-I has been shown to reduce effectively the risk of endophthalmitis in various ocular procedures, including cataract surgery and intravitreal injections; however, it has also been used in the treatment of conjunctivitis, keratitis, and endophthalmitis, with promising results especially in low-resource situations. PVP-I has been associated with complications such as postoperative eye pain, persistent corneal epithelial defects, ocular inflammation, and an attendant risk of keratitis. In cases of poor PVP-I tolerance, applying PVP-I at lower concentrations or using alternative antiseptics such as chlorhexidine should be considered. We provide an update on the efficacy of PVP-I in the prophylaxis and treatment of conjunctivitis, keratitis, and endophthalmitis and a comprehensive analysis of the current literature regarding the use of PVP-I in the management of these ocular conditions. Also, PVP-I-related adverse effects and toxicities and its alternatives are discussed. The goal is to present a thorough evaluation of the available evidence and to offer practical recommendations for clinicians regarding the therapeutic usage of PVP-I in ophthalmology.
Topics: Humans; Povidone-Iodine; Ophthalmology; Polyvinyls; Anti-Infective Agents, Local; Iodine; Cataract Extraction; Endophthalmitis; Povidone; Conjunctivitis; Keratitis; Water
PubMed: 37944600
DOI: 10.1016/j.survophthal.2023.11.002 -
MicrobiologyOpen Sep 2020Ethanol and povidone-iodine (PVP-I) are important microbicides that inactivate bacteria and viruses. The present study provides a review of literature data on the... (Review)
Review
Ethanol and povidone-iodine (PVP-I) are important microbicides that inactivate bacteria and viruses. The present study provides a review of literature data on the concentration-dependent bactericidal and virucidal activity of ethanol and PVP-I in vitro. A systematic search was performed using the meta-database for biomedicine PubMed. Eventually, 74 studies with original data on the reduction of bacterial and viral infectivity using in vitro tests were analyzed. A safe bactericidal effect of ethanol can be expected at concentrations between 60% and 85%, and the exposure times vary between ≤0.5 and ≥5 min. Within an exposure of up to 5 min, 80%-90% ethanol also exerts virucidal/low-level activity, which includes its action against enveloped viruses plus adeno-, noro-, and rotaviruses. For PVP-I, the best bactericidal and virucidal/high-level effect is present at a concentration range of approx. 0.08%-0.9% depending on the free iodine concentration. The maximum exposure times are 5 min for bacteria and 60 min for viruses. The available data may help optimize the significant inactivation of bacteria and viruses in various areas. However, as the conditions in application practice can vary, concrete recommendations for the application can only be derived to a limited extent.
Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Antiviral Agents; Bacteria; Disinfectants; Ethanol; Microbial Sensitivity Tests; Microbial Viability; Povidone-Iodine; Viruses
PubMed: 32567807
DOI: 10.1002/mbo3.1097 -
Journal of Ocular Pharmacology and... Apr 2023Povidone-iodine (PVI), also known as Betadine, is a widely used antiseptic agent used in several fields of medicine. In ophthalmology, it is applied as a preoperative... (Review)
Review
Povidone-iodine (PVI), also known as Betadine, is a widely used antiseptic agent used in several fields of medicine. In ophthalmology, it is applied as a preoperative antiseptic to prevent infectious complications that can result from surgical procedures. PVI's safety and efficacy have been extensively studied and represented in the literature; however, the incidence of adverse effects has been reported in conjunction. The aim of this paper is to compile information regarding PVIs use, safety profile, adverse effects, and possible alternatives through a review of the existing literature. Literature was compiled utilizing the database PubMed and Google Scholar using specified keywords with a total of 86 reviewed articles, after excluding search results that did not meet the inclusion criteria. While the allergic potential to PVI is a highly contested topic, there are several nonallergic adverse effects of PVI that should not be overlooked. These effects include chemical burn, cytotoxic effects, and general patient discomfort. In light of these adverse effects, alternatives to PVI may be considered. However, there has been little research identifying feasible alternatives in preoperative intraocular procedures. Alternatives including chlorhexidine, polyhexamethylene biguanide (polyhexanide), and octenidine were identified as potential substitutes for PVI. Further study is needed to provide robust evidence regarding the efficacy profiles of these alternatives in comparison with PVI and to demonstrate comparable tolerance to PVI in intraocular procedures.
Topics: Humans; Povidone-Iodine; Surgical Wound Infection; Anti-Infective Agents, Local; Chlorhexidine; Ophthalmology; Drug-Related Side Effects and Adverse Reactions
PubMed: 36763602
DOI: 10.1089/jop.2022.0122 -
Pediatrics International : Official... 2023Povidone-iodine (10%; PI) and 2% chlorhexidine in 70% isopropyl alcohol (CHG-IA) solutions are among the most widely used disinfectants in the neonatal intensive care... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Povidone-iodine (10%; PI) and 2% chlorhexidine in 70% isopropyl alcohol (CHG-IA) solutions are among the most widely used disinfectants in the neonatal intensive care units. This study compares the use of these disinfectants and helps decide which is superior to the other for neonatal use.
METHODS
All term and preterm infants born and hospitalized in Bursa Uludag University Hospital between July 2018-March 2020 were included. The infants were randomized into two disinfectant groups before birth. The application site was cleaned with the assigned disinfectant before intervention. The infants were screened for rates of neonatal sepsis, thyroid-stimulating hormone (TSH) levels, free thyroxine (fT4) levels, skin reactions to the assigned solution, and acute neurological side effects.
RESULTS
We enrolled 208 term and preterm infants (PI:104 vs. CHG-IA: 104) in the study. The prematurity rates were identical (PI: 74.0%; CHG-IA: 72.1%; p = 0.755). Neonatal sepsis rates among these groups were not statistically different (PI: 8.7%; CHG-IA: 4.8%; p = 0.406). The median TSH value of the PI group was high (4.05 mIU/L) in comparison with that of the CHG-IA group (3.09 mIU/L; p = 0.016). No cutaneous or neurological side effects were recorded in patients treated with CHG-IA solution.
CONCLUSIONS
Although these two solutions were equally protective against infections, the CHG-IA solution was a better alternative to PI for neonatal use. Considering that the PI solution may be responsible for impaired thyroid function, the CHG-IA solution is a good alternative because it provides sufficient protection with a safer adverse effect profile.
Topics: Humans; Infant, Newborn; Chlorhexidine; Disinfectants; Infant, Premature; Intensive Care Units, Neonatal; Neonatal Sepsis; Povidone-Iodine; Thyrotropin
PubMed: 37350581
DOI: 10.1111/ped.15552 -
Biological & Pharmaceutical Bulletin Sep 2023Personal protective equipment (PPE), including medical masks, should be worn for preventing the transmission of respiratory pathogens via infective droplets and...
Personal protective equipment (PPE), including medical masks, should be worn for preventing the transmission of respiratory pathogens via infective droplets and aerosols. In medical masks, the key layer is the filter layer, and the melt-blown nonwoven fabric (NWF) is the most used fabric. However, the NWF filter layer cannot kill or inactivate the pathogens spread via droplets and aerosols. Povidone-iodine (PVP-I) has been used as an antiseptic solution given its potent broad-spectrum activity against pathogens. To develop PPE (e.g., medical masks) with anti-pathogenic activity, we integrated PVP-I into nylon-66 NWF. We then evaluated its antiviral activity against influenza A viruses by examining the viability of Madin-Darby canine kidney (MDCK) cells after inoculation with the virus strains exposed to the PVP-I-integrated nylon-66 NWF. The PVP-I nylon-66 NWF protected the MDCK cells from viral infection in a PVP-I concentration-dependent manner. Subsequently, we found to integrate PVP-I into nylon-66 and polyurethane materials among various materials. These PVP-I materials were also effective against influenza virus infection, and treatment with PVP-I nylon-66 NWF showed the highest cell survival among all the tested materials. PVP-I showed anti-influenza A virus activity when used in conjunction with PPE materials. Moreover, nylon-66 NWF integrated with PVP-I was found to be the best material to ensure anti-influenza activity. Therefore, PVP-I-integrated masks could have the potential to inhibit respiratory virus infection. Our results provide new information for developing multi-functional PPEs with anti-viral activity by integrating them with PVP-I to prevent the potential transmission of respiratory viruses.
Topics: Animals; Dogs; Humans; Povidone-Iodine; Nylons; Respiratory Aerosols and Droplets; Influenza, Human; Orthomyxoviridae
PubMed: 37357386
DOI: 10.1248/bpb.b23-00161 -
Biological Trace Element Research Aug 2022Iodine-based mouthwash and throat sprays contain povidone iodine (PVP-I) for disinfection. PVP-I mouthwash has been commonly used for decades in Japan and other...
Iodine-based mouthwash and throat sprays contain povidone iodine (PVP-I) for disinfection. PVP-I mouthwash has been commonly used for decades in Japan and other countries and frequent and/or prolonged use of PVP-I mouthwash can induce transient hypothyroidism. To assess the amount of iodine ingested from an oral rinse, 22 healthy adult volunteers (mean age: 48.1, 29-70 years) were recruited for the study. The subjects were instructed to rinse for 15 s three times with 20 mL of commercially available PVP-I mouthwash diluted into 0.23% or pure water. This method is a standardized method of gargling recommended by the manufacturers. The total iodine in the PVP-I mouthwash was measured with inductively coupled plasma-mass spectrometry. Although the 7% PVP-I mouthwash contains 7 mg of effective iodine/mL, 24.3 mg/mL of iodine was detected in the solution. The median value and ratio of the total iodine ingested were 5.0 mg (range: 2.6-10.8 mg) and 20.5% (range: 10.6-44.5%), respectively. The iodine species released from the PVP-I mouthwash are effective iodine (PVP・nHI, I, and I) and I; however, the amount and types of iodine actually absorbed into the bloodstream are unknown. PVP-I mouthwash should be used carefully since around 5 mg of iodine could theoretically enter the body with one gargle which exceeds the tolerable upper intake level of iodine for adults. This study was prospectively registered to University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) on March 29, 2021, with the study ID of UMIN000043770.
Topics: Adult; Eating; Humans; Hypothyroidism; Iodides; Iodine; Mouthwashes; Povidone-Iodine
PubMed: 34674109
DOI: 10.1007/s12011-021-02978-7 -
Annals of Medicine Dec 2022Accumulating data suggest antiviral effects of povidone-iodine against the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. This narrative review aims... (Review)
Review
BACKGROUND
Accumulating data suggest antiviral effects of povidone-iodine against the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. This narrative review aims to examine the antiviral mechanisms of povidone-iodine, efficacy of povidone-iodine against the SARS-CoV-2 virus, and safety of povidone-iodine to human epithelial cells and thyroid function.
METHODS
We searched the electronic databases PubMed, Embase, Cochrane Library, ClinicalTrials.gov and World Health Organization's International Clinical Trials Registry Platform for articles containing the keywords "povidone-iodine", "SARS-CoV-2" and "COVID-19" from database inception till 3 June 2021.
RESULTS
Despite data supporting the anti-SARS-CoV-2 effects of povidone-iodine, findings from clinical studies revealed differences in treatment response depending on study settings (healthy hospitalized individuals), treatment target (nasal oral pharynx), method of administration (oral rinse gargle throat spray) and choice of samples used to measure study endpoints (nasopharyngeal saliva). One large-scale clinical trial demonstrated reduction in the incidence of SARS-CoV-2 infection among participants who administered povidone-iodine 3 times daily during an active outbreak. Povidone-iodine is also used to disinfect the oro-pharyngeal space prior to dental or otolaryngology procedures. Although existing data suggest minimal impact of povidone-iodine on thyroid function, high-quality safety data are presently lacking.
CONCLUSIONS
Povidone-iodine application to the oropharyngeal space could complement existing non-pharmacological interventions to reduce SARS-CoV-2 infection especially in high exposure settings.Key messagesAccumulating data suggest antiviral effects of povidone-iodine against the SARS-CoV-2 virus.Findings from clinical studies reveal differences in treatment response depending on study settings, treatment target, method of administration and choice of samples used to measure study endpoints. One large-scale clinical trial observed reduction in the incidence of SARS-CoV-2 infection among participants who administered povidone-iodine 3 times daily during an active outbreak.Povidone-iodine application to the oropharyngeal space could complement existing non-pharmacological interventions to reduce SARS-CoV-2 infection especially in high exposure settings.
Topics: Antiviral Agents; COVID-19; Humans; Mouthwashes; Povidone-Iodine; SARS-CoV-2
PubMed: 35594333
DOI: 10.1080/07853890.2022.2076902 -
Archives of Orthopaedic and Trauma... Apr 2023One of the most important challenges faced by orthopedic surgeons is periprosthetic joint infection (PJI). PJI is a common cause for total joint arthroplasty failure...
INTRODUCTION
One of the most important challenges faced by orthopedic surgeons is periprosthetic joint infection (PJI). PJI is a common cause for total joint arthroplasty failure with an incidence of 0.3-1.9%. PJI can be devastating for the patient and extremely costly for the healthcare system. There is concern that a major cause of PJI is intra-operative colonization and recent studies have shown a decrease in PJI with the use of dilute povidone-iodine (Betadine, Avrio Health L.P, Stamford, CT) irrigation prior to wound closure. This study presents our experience with the use of dilute Betadine irrigation prior to wound closure and its effect on our post-operative hip and knee arthroplasty acute infection rate.
MATERIALS AND METHODS
Retrospective chart review performed at our hospital looking at PJI amongst patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) between 2013 and 2017 comparing different irrigation methods (n = 3232). The study group (n = 1207) underwent irrigation prior to wound closure with dilute Betadine for 3 min and the control group (n = 1511) underwent irrigation using normal saline (NS).
RESULTS
Using a logistic regression model where the following variables were adjusted for; ASA, age, sex, foley insertion, surgical duration and diabetes mellitus status a statistical significant reduction was seen in any infection (OR 0.45 [0.22; 0.89], p value < 0.05) and SSI (OR 0.30 [0.13; 0.70], p value 0.01) with the Betadine group. No significant reduction was seen with deep infections with the Betadine group compared to the NS group.
CONCLUSION
PJI is a devastating complication following total joint arthroplasty and we found Betadine compared to NS irrigation provides an inexpensive and simple method to lower any PJI and more specifically SSI in THA and TKA.
LEVEL OF EVIDENCE
III.
Topics: Humans; Povidone-Iodine; Arthroplasty, Replacement, Knee; Retrospective Studies; Prosthesis-Related Infections; Arthroplasty, Replacement, Hip; Arthritis, Infectious
PubMed: 35488919
DOI: 10.1007/s00402-022-04451-z -
Tropical Biomedicine Dec 2020Coronavirus Disease 2019 (COVID-19) has infected more than 8 million people globally since its discovery in December 2019. For COVID-19 prevention, the World Health... (Review)
Review
Coronavirus Disease 2019 (COVID-19) has infected more than 8 million people globally since its discovery in December 2019. For COVID-19 prevention, the World Health Organization recommended regular handwashing with soap, cough etiquette, mask wearing and social distancing. However, COVID-19 is rather difficult to contain because of its high transmissibility property. Gargling is effective for reducing infection in the respiratory tract. Most antiseptic gargles have antimicrobial properties against common respiratory pathogens. No published study on the effectiveness of antiseptic gargling among COVID-19 patients has been available to date. This article reviewed available literature on methods and solutions available for gargling and their effect on respiratory tract infections.
Topics: Anti-Infective Agents, Local; COVID-19; Chlorhexidine; Humans; Povidone-Iodine
PubMed: 33612766
DOI: 10.47665/tb.37.4.1141