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Contact Lens & Anterior Eye : the... Feb 2023To determine the frequency and severity of ocular symptoms and signs in new orthokeratology (ortho-k) subjects using a povidone iodine (PI) disinfecting system compared... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To determine the frequency and severity of ocular symptoms and signs in new orthokeratology (ortho-k) subjects using a povidone iodine (PI) disinfecting system compared to those present before lens wear, and whether these were associated with cleaning regimes.
METHODS
This study recruited 80 subjects from two myopia control studies, who used a PI disinfecting solution for routine use. Ocular symptoms and signs at baseline, one- and six-month after lens wear were reported via questionnaires and ocular examination, respectively. To determine if rates of occurrence were attributable to differences in cleaning regime, subjects were randomly assigned into four groups with respect to routine care procedures, which involved various combinations of rubbing and use of a daily and/or enzymatic cleaner.
RESULTS
Sixty-eight subjects completed all aspects of the study. As there were no significant differences in incidence of signs and symptoms between the four groups before and after lens wear (Friedman tests, p > 0.07), data were combined for further analysis. Prior to lens wear, itchiness (69 %) and dryness (53 %) were the most commonly reported symptoms. The frequency and severity of all symptoms remained similar after lens wear (p > 0.10). Presence of follicles in the lower tarsal conjunctiva (22 %) and conjunctival injection (15 %) was frequently observed, but reduced significantly after lens wear (p < 0.01). Mild corneal staining, noted in 13 % of subjects at baseline, did not change significantly over time (p = 0.17). Ocular signs were not necessarily reflected in symptoms and vice versa.
CONCLUSION
Use of a PI-based solution did not increase the frequency or severity of ocular signs and symptoms observed before lens wear. Absence of a difference in occurrence of ocular discomfort with respect to cleaning regimes indicated that the use of the PI-based solution may adequately clean the lenses over a 6-month period.
Topics: Humans; Povidone-Iodine; Vision, Ocular; Myopia; Lens, Crystalline; Conjunctiva
PubMed: 35931598
DOI: 10.1016/j.clae.2022.101742 -
Ear, Nose, & Throat Journal Apr 2021Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the global pandemic of coronavirus disease 2019 (COVID-19). From the first...
INTRODUCTION
Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the global pandemic of coronavirus disease 2019 (COVID-19). From the first reported cases in December 2019, the virus has spread to over 4 million people worldwide. Human-to-human transmission occurs mainly through the aerosolization of respiratory droplets. Transmission also occurs through contact with contaminated surfaces and other fomites. Improved antisepsis of human and nonhuman surfaces has been identified as a key feature of transmission reduction. There are no previous studies of povidone iodine (PVP-I) against SARS-CoV-2. This study evaluated nasal and oral antiseptic formulations of PVP-I for virucidal activity against SARS-CoV-2. This is the first report on the efficacy of PVP-I against the virus that causes COVID-19.
METHODS
Povidone iodine nasal antiseptic formulations and PVP-I oral rinse antiseptic formulations from 1% to 5% concentrations as well as controls were studied for virucidal efficacy against the SARS-CoV-2. Test compounds were evaluated for ability to inactivate SARS-CoV-2 as measured in a virucidal assay. SARS-CoV-2 was exposed directly to the test compound for 60 seconds, compounds were then neutralized, and surviving virus was quantified.
RESULTS
All concentrations of nasal antiseptics and oral rinse antiseptics evaluated completely inactivated the SARS-CoV-2.
CONCLUSIONS
Nasal and oral PVP-I antiseptic solutions are effective at inactivating the SARS-CoV-2 at a variety of concentrations after 60-second exposure times. The formulations tested may help to reduce the transmission of SARS-CoV-2 if used for nasal decontamination, oral decontamination, or surface decontamination in known or suspected cases of COVID-19.
Topics: Administration, Topical; Anti-Infective Agents, Local; COVID-19; Humans; In Vitro Techniques; Microbial Viability; Mouth Mucosa; Mouthwashes; Nasal Lavage; Nasal Mucosa; Povidone-Iodine; SARS-CoV-2
PubMed: 32951446
DOI: 10.1177/0145561320957237 -
Odontology Apr 2022This study aimed to systematically review the literature about the virucidal efficacy of CHX in comparison to other substances used in the oral cavity. Electronic...
This study aimed to systematically review the literature about the virucidal efficacy of CHX in comparison to other substances used in the oral cavity. Electronic searches were performed in four databases (PubMed, Scopus, Embase, and Web of Science). Only studies that presented the following characteristics were included: (1) verified virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1), any Influenza, or any human coronavirus (HcoV); and (2) compared the virucidal efficacy of CHX with essential oils (Listerine), quaternary ammonium compounds, povidone-iodine, hydrogen peroxide, negative control substance, and absence of therapy. Two researchers independently selected the studies, extracted data and evaluated the risk of bias. A narrative data synthesis was used. Twenty-five studies were included, of which 21 were in vitro and four were randomized clinical trials (RCT). Studies assessed the virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1) (10 studies), Influenza A (InfluA) (4 studies), human coronavirus (HCoV) (4 studies) and Severe Acute Respiratory Syndrome-Related Coronavirus (SARS-CoV-2) (11 studies). Most studies demonstrated that CHX has a positive virucidal efficacy against HSV-1 and InfluA strains. However, lower efficacy was shown to InfluA strain in comparison to povidone-iodine. Lower to none virucidal efficacy of CHX is expected for HCoV and SARS-CoV-2 strains for in vitro studies. Three RCT demonstrated that CHX was able to significantly reduce the viral load of SARS-CoV-2 for a short period. CHX may present an interesting virucidal efficacy against HSV-1 and InfluA viruses. CHX also presents transient efficacy against SARS-CoV-2 when used as a mouthwash.
Topics: COVID-19; Chlorhexidine; Humans; Mouthwashes; Povidone-Iodine; SARS-CoV-2
PubMed: 34637092
DOI: 10.1007/s10266-021-00660-x -
The Japanese Dental Science Review Nov 2021The Coronavirus disease in 2019 (COVID-19), also referred to as the novel 'CoV19 (nCov19)' is caused by a new coronavirus strain similar to Severe Acute Respiratory... (Review)
Review
Can povidone iodine gargle/mouthrinse inactivate SARS-CoV-2 and decrease the risk of nosocomial and community transmission during the COVID-19 pandemic? An evidence-based update.
The Coronavirus disease in 2019 (COVID-19), also referred to as the novel 'CoV19 (nCov19)' is caused by a new coronavirus strain similar to Severe Acute Respiratory Syndrome (SARS-CoV-2). SARS-CoV-2 spreads via respiratory droplets, saliva, or direct contact. Therefore it is important to control the viral load in the saliva and respiratory secretions. One of the most simple and cost-effective measures that can be adopted by the public and healthcare professionals to prevent cross-contamination and community transmission, is the implementation of effective oral and throat hygiene. Recent evidence has confirmed that 0.5% povidone iodine (PVP-I) mouthrinse/gargle for 30 s can reduce SARS-CoV-2 virus infectivity to below detectable levels. PVP-I can even interrupt SARS-CoV-2 attachment to oral and nasopharyngeal tissues and lower the viral particles in the saliva and respiratory droplets. Thus, the use of PVP-I mouthrinse as a prophylactic measure has been advocated across the globe to reduce disease transmission. Although the efficacy of PVP-I against SARS-CoV-2 is proven, no review articles have yet discussed the evidence and mechanisms of PVP-I against the SARS-CoV-2. Thus, this paper highlights the rationale, safety, recommendations, and dosage of PVP-I gargle/mouthrinse as an effective method to decrease the viral loads during the pressing times of COVID-19.
PubMed: 33747261
DOI: 10.1016/j.jdsr.2021.03.001 -
The Cochrane Database of Systematic... Mar 2022Viruses cause about 80% of all cases of acute conjunctivitis. Human adenoviruses are believed to account for 65% to 90% of cases of viral conjunctivitis, or 20% to 75%... (Review)
Review
BACKGROUND
Viruses cause about 80% of all cases of acute conjunctivitis. Human adenoviruses are believed to account for 65% to 90% of cases of viral conjunctivitis, or 20% to 75% of all causes of infectious keratoconjunctivitis worldwide. Epidemic keratoconjunctivitis (EKC) is a highly contagious subset of adenoviral conjunctivitis that has been associated with large outbreaks at military installations and at medical facilities. It is accompanied by severe conjunctival inflammation, watery discharge, and light sensitivity, and can lead to chronic complications such as corneal and conjunctival scarring with discomfort and poor quality of vision. Due to a lack of consensus on the efficacy of any pharmacotherapy to alter the clinical course of EKC, no standard of care exists, therefore many clinicians offer only supportive care.
OBJECTIVES
To assess the efficacy and safety of topical pharmacological therapies versus placebo, an active control, or no treatment for adults with EKC.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL, which contains the Cochrane Eyes and Vision Trials Register; 2021, Issue 4); Ovid MEDLINE; Ovid Embase; Latin American and Caribbean Health Sciences database (LILACS); ClinicalTrials.gov; and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), with no restrictions on language or year of publication. The date of the last search was 27 April 2021.
SELECTION CRITERIA
We included randomized controlled trials in which antiseptic agents, virustatic agents, or topical immune-modulating therapy was compared with placebo, an active control, or no treatment.
DATA COLLECTION AND ANALYSIS
We used standard Cochrane methodology.
MAIN RESULTS
We identified 10 studies conducted in Asia, Europe, the Middle East, and North Africa with a total of 892 participants who were treated for 7 days to 6 months and followed for 7 days up to 1.5 years. Study characteristics and risk of bias In most studies participants were predominantly men (range: 44% to 90%), with an age range from 9 to 82 years. Three studies reported information on trial registration, but we found no published study protocol. The majority of trials had small sample sizes, ranging from 18 to 90 participants enrolled per study; the only exception was a trial that enrolled 350 participants. We judged most studies to be at high or unclear risk of bias across risk of bias domains. Findings We included 10 studies of 892 EKC participants and estimated combined intervention effects in analyses stratified by steroid-containing control treatment or artificial tears. Six trials contributed to the comparisons of topical interventions (povidone-iodine [PVP-I], trifluridine, ganciclovir, dexamethasone plus neomycin) with artificial tears (or saline). Very low certainty evidence from two trials comparing trifluridine or ganciclovir with artificial tears showed inconsistent effects on shortening the mean duration of cardinal symptoms or signs of EKC. Low certainty evidence based on two studies (409 participants) indicated that participants treated with PVP-I alone more often experienced resolution of symptoms (risk ratio (RR) 1.15, 95% confidence interval (CI) 1.07 to 1.24) and signs (RR 3.19, 95% CI 2.29 to 4.45) during the first week of treatment compared with those treated with artificial tears. Very low certainty evidence from two studies (77 participants) suggested that PVP-I or ganciclovir prevented the development of subepithelial infiltrates (SEI) when compared with artificial tears within 30 days of treatment (RR 0.24, 95% CI 0.10 to 0.56). Four studies compared topical interventions (tacrolimus, cyclosporin A [CsA], trifluridine, PVP-I + dexamethasone) with topical steroids, and one trial compared fluorometholone (FML) plus polyvinyl alcohol iodine (PVA-I) with FML plus levofloxacin. Evidence from one trial showed that more eyes receiving PVP-I 1.0% plus dexamethasone 0.1% had symptoms resolved by day seven compared with those receiving dexamethasone alone (RR 9.00, 95% CI 1.23 to 66.05; 52 eyes). In two trials, fewer eyes treated with PVP-I or PVA-I plus steroid developed SEI within 15 days of treatment compared with steroid alone or steroid plus levofloxacin (RR 0.08, 95% CI 0.01 to 0.55; 69 eyes). One study found that CsA was no more effective than steroid for resolving SEI within four weeks of treatment (RR 0.84, 95% CI 0.67 to 1.06; N = 88). The evidence from trials comparing topical interventions with steroids was overall of very low level certainty. Adverse effects Antiviral or antimicrobial agents plus steroid did not differ from artificial tears in terms of ocular discomfort upon instillation (RR 9.23, 95% CI 0.61 to 140.67; N = 19). CsA and tacrolimus eye drops were associated with more cases of severe ocular discomfort, and sometimes intolerance, when compared with steroids (RR 4.64, 95% CI 1.15 to 18.71; 2 studies; N = 141). Compared with steroids, tacrolimus did not increase the risk of elevated intraocular pressure (RR 0.07, 95% CI 0 to 1.13; 1 study; N = 80), while trifluridine conferred no additional risk compared to tear substitute (RR 5.50, 95% CI 0.31 to 96.49; 1 study; N = 97). Overall, bacterial superinfection was rare (one in 23 CsA users) and not associated with use of the intervention steroid (RR 3.63, 95% CI 0.15 to 84.98; N = 51). The evidence for all estimates was of low or very low certainty.
AUTHORS' CONCLUSIONS
The evidence for the seven specified outcomes was of low or very low certainty due to imprecision and high risk of bias. The evidence that antiviral agents shorten the duration of symptoms or signs when compared with artificial tears was inconclusive. Low certainty evidence suggests that PVP-I alone resolves signs and symptoms by seven days relative to artificial tears. PVP-I or PVA-I, alone or with steroid, is associated with lower risks of SEI development than artificial tears or steroid (very low certainty evidence). The currently available evidence is insufficient to determine whether any of the evaluated interventions confers an advantage over steroids or artificial tears with respect to virus eradication or its spread to initially uninvolved fellow eyes. Future updates of this review should provide evidence of high-level certainty from trials with larger sample sizes, enrollment of participants with similar durations of signs and symptoms, and validated methods to assess short- and long-term outcomes.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Conjunctivitis; Conjunctivitis, Viral; Cyclosporine; Dexamethasone; Female; Fluorometholone; Ganciclovir; Humans; Keratoconjunctivitis; Levofloxacin; Lubricant Eye Drops; Male; Middle Aged; Povidone-Iodine; Tacrolimus; Trifluridine; Young Adult
PubMed: 35238405
DOI: 10.1002/14651858.CD013520.pub2 -
Journal of International Society of... 2020Patients are mask-free during dental attention. In addition, dentists and dental staff after working for hours need to hydrate or eat. Removing the mask makes them... (Review)
Review
OBJECTIVES
Patients are mask-free during dental attention. In addition, dentists and dental staff after working for hours need to hydrate or eat. Removing the mask makes them vulnerable to the risk of contamination. For those cases, a prophylactic decontamination protocol could be useful as an adjunct to the most recommended biosecurity protocols. This article aims to provide a comprehensive review of the published evidence about the use of povidone-iodine (PVP-I) against SARS-CoV-2 and to propose a prophylactic protocol for dental attention using PVP-I during the COVID-19 pandemic.
MATERIALS AND METHODS
An electronic search in Medline via PubMed, Scopus, Cochrane Library and Scielo databases was performed up to July 24, 2020, to identify relevant literature focusing on Povidone Iodine, SARS-CoV-2, COVID-19, SARS-COV, MERS, antiviral mouthwashes, and oral cavity.
RESULTS
Clinical studies on the virucidal effectiveness of PVP-I against SARS-CoV-2 have not yet been reported. We identify a recent study showing PVP-I effectiveness at 0.5, 1, and 1.5% within 15s of contact. Moreover, another study has shown ≥99.99% virucidal activity as 1% mouthwash and 0.45% throat spray. The only study in SARS-CoV-2 confirmed patients reported a significant 3h drop in viral load after rinsing with 15 mL of 1% PVP-I for 1min.
CONCLUSIONS
Although no clinical trials have reported the efficacy of PVP-I on SARS-CoV-2, recent studies in patients with positive PCR to SARS-CoV-2 found a significant 3-h drop in viral load. We believe that an oral prophylactic protocol with PVP-I for dental healthcare workers and patients as an adjunct to the current biosecurity protocol could minimize the transmission risk during COVID-19 pandemic.
PubMed: 33437699
DOI: 10.4103/jispcd.JISPCD_304_20 -
Future Microbiology Jan 2021A review of nasal sprays and gargles with antiviral properties suggests that a number of commonly used antiseptics including povidone-iodine, Listerine,... (Review)
Review
A review of nasal sprays and gargles with antiviral properties suggests that a number of commonly used antiseptics including povidone-iodine, Listerine, iota-carrageenan and chlorhexidine should be studied in clinical trials to mitigate both the progression and transmission of SARS-CoV-2. Several of these antiseptics have demonstrated the ability to cut the viral load of SARS-CoV-2 by 3-4 log in 15-30 s . In addition, hypertonic saline targets viral replication by increasing hypochlorous acid inside the cell. A number of clinical trials are in process to study these interventions both for prevention of transmission, prophylaxis after exposure, and to diminish progression by reduction of viral load in the early stages of infection.
Topics: Anti-Infective Agents, Local; COVID-19; Carrageenan; Chlorhexidine; Drug Combinations; Hydrogen Peroxide; Nasal Sprays; Oils, Volatile; Povidone-Iodine; SARS-CoV-2; Salicylates; Terpenes; Viral Load
PubMed: 33464122
DOI: 10.2217/fmb-2020-0286 -
BMC Nephrology May 2024Exit-site infection (ESI) is a common recurring complication in patients undergoing peritoneal dialysis (PD). Sucrose and povidone-iodine (SPI) mixtures, antimicrobial... (Observational Study)
Observational Study
BACKGROUND
Exit-site infection (ESI) is a common recurring complication in patients undergoing peritoneal dialysis (PD). Sucrose and povidone-iodine (SPI) mixtures, antimicrobial ointments that promote wound healing, have been used for the treatment of ulcers and burns, but their efficacy in exit-site care is still unclear.
METHODS
This single-center retrospective observational study included patients who underwent PD between May 2010 and June 2022 and presented with episodes of ESI. Patients were divided into SPI and non-SPI groups and followed up from initial ESI onset until PD cessation, death, transfer to another facility, or June 2023.
RESULTS
Among the 82 patients (mean age 62, [54-72] years), 23 were treated with SPI. The median follow-up duration was 39 months (range, 14-64), with an overall ESI incidence of 0.70 episodes per patient-year. Additionally, 43.1% of second and 25.6% of third ESI were caused by the same pathogen as the first. The log-rank test demonstrated significantly better second and third ESI-free survival in the SPI group than that in the non-SPI group (p < 0.01 and p < 0.01, respectively). In a Cox regression analysis, adjusting for potential confounders, SPI use was a significant predictor of decreased second and third ESI episodes (hazard ratio [HR], 0.22; 95% confidence interval [CI], 0.10-0.52 and HR, 0.22; 95%CI, 0.07-0.73, respectively).
CONCLUSIONS
Our results showed that the use of SPI may be a promising option for preventing the incidence of ESI in patients with PD.
TRIAL REGISTRATION
This study was approved by the Keio University School of Medicine Ethics Committee (approval number 20231078) on August 28, 2023. Retrospectively registered.
Topics: Humans; Povidone-Iodine; Middle Aged; Retrospective Studies; Male; Female; Aged; Sucrose; Anti-Infective Agents, Local; Peritoneal Dialysis; Catheter-Related Infections; Catheters, Indwelling; Treatment Outcome
PubMed: 38698327
DOI: 10.1186/s12882-024-03591-1 -
Journal of Ocular Pharmacology and... May 2022Intravitreal injection has become a popular treatment for various retina disorders and dramatically increased over the past few years. In traditional preintravitreal...
Intravitreal injection has become a popular treatment for various retina disorders and dramatically increased over the past few years. In traditional preintravitreal injection, the preparation steps are time consuming for practitioners who perform a significant number of injections per day. Besides, lidocaine gel (L-Gel) shows a potential absorption barrier on the antibacterial effect of povidone iodine (PI). In this study, we describe a L/PI gel system as an alternative approach to address these issues for traditional preinjection drug administration. Lidocaine and PI are loaded in a thermoresponsive gel instilled as a liquid to the lower fornix that transitions to a stable, solid gel depot. The gel demonstrated decrease in conjunctival touch sensitivity and sufficient bacteria killing with a single step, suggesting a significant decrease in the time required and less potential for drug inhibition due to sequential administration.
Topics: Anti-Infective Agents, Local; Conjunctiva; Intravitreal Injections; Lidocaine; Povidone-Iodine
PubMed: 35255227
DOI: 10.1089/jop.2021.0095 -
European Journal of Case Reports in... 2022Chyluria is usually associated with parasitic disease caused by and is rare in non-endemic regions. The management of chyluria varies according to the severity of the...
BACKGROUND
Chyluria is usually associated with parasitic disease caused by and is rare in non-endemic regions. The management of chyluria varies according to the severity of the condition. This report describes a case of mild chyluria and successful treatment using sclerotherapy.
CASE DESCRIPTION
A 44-year-old man presented with a first episode of painless milky urine. The diagnosis of chyluria was established following retrograde pyelography showing a fistula between the right pelviocalyces and the retroperitoneal lymphatic systems. The patient had not travelled to any endemic regions. Sclerotherapy using povidone-iodine was carried out resulting in closure of the fistula.
CONCLUSION
Sclerotherapy using povidone-iodine as the sclerosing agent was effective and safe for the management of a patient with mild chyluria. However, the best treatment for chyluria should be tailored to the patient's condition.
LEARNING POINTS
Treatment of chyluria with instillation of povidone-iodine as a sclerosing agent provides an excellent outcome.The treatment of chyluria is should be tailored to disease severity.
PubMed: 35520366
DOI: 10.12890/2022_003336