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International Journal of Surgery... Aug 2017Of the many antimicrobial agents available, iodophore-based formulations such as povidone iodine have remained popular after decades of use for antisepsis and wound... (Review)
Review
BACKGROUND
Of the many antimicrobial agents available, iodophore-based formulations such as povidone iodine have remained popular after decades of use for antisepsis and wound healing applications due to their favorable efficacy and tolerability. Povidone iodine's broad spectrum of activity, ability to penetrate biofilms, lack of associated resistance, anti-inflammatory properties, low cytotoxicity and good tolerability have been cited as important factors, and no negative effect on wound healing has been observed in clinical practice. Over the past few decades, numerous reports on the use of povidone iodine have been published, however, many of these studies are of differing design, endpoints, and quality. More recent data clearly supports its use in wound healing.
METHODS
Based on data collected through PubMed using specified search criteria based on above topics and clinical experience of the authors, this article will review preclinical and clinical safety and efficacy data on the use of povidone iodine in wound healing and its implications for the control of infection and inflammation, together with the authors' advice for the successful treatment of acute and chronic wounds.
RESULTS AND CONCLUSION
Povidone iodine has many characteristics that position it extraordinarily well for wound healing, including its broad antimicrobial spectrum, lack of resistance, efficacy against biofilms, good tolerability and its effect on excessive inflammation. Due to its rapid, potent, broad-spectrum antimicrobial properties, and favorable risk/benefit profile, povidone iodine is expected to remain a highly effective treatment for acute and chronic wounds in the foreseeable future.
Topics: Anti-Infective Agents, Local; Humans; Povidone-Iodine; Surgical Wound Infection; Wound Healing
PubMed: 28648795
DOI: 10.1016/j.ijsu.2017.06.073 -
British Dental Journal Jun 2020
Topics: Povidone-Iodine
PubMed: 32541700
DOI: 10.1038/s41415-020-1725-1 -
Survey of Ophthalmology 2018Iodine has been recognized as an effective bactericide since the 1800s, and povidone-iodine (PI) solution has been applied to the ocular surface and periocular skin... (Review)
Review
Iodine has been recognized as an effective bactericide since the 1800s, and povidone-iodine (PI) solution has been applied to the ocular surface and periocular skin since the 1980s to prevent endophthalmitis in cataract surgery. In vitro, PI solution kills bacteria quickly at dilute concentrations (0.05%-1.0%). In many instances, PI kills bacteria more quickly at these dilute concentrations than more conventional (5%-10%) concentrations. This is due to greater availability of diatomic free iodine in dilute solution, the bactericidal component of PI. The toxicity of PI, both in vitro and clinically, has been shown to be related to concentration. Current American Academy of Ophthalmology and the European Society of Cataract and Refractive Surgeons recommendations regarding PI use suggest using 5% PI before surgery. An alternative dosing strategy uses dilute PI repetitively throughout cataract surgery (0.25% every 30 seconds). We review the povidone-iodine literature with attention to basic science and use of dilute PI.
Topics: Anti-Bacterial Agents; Cataract Extraction; Endophthalmitis; Eye Infections, Bacterial; Humans; Povidone-Iodine
PubMed: 29778494
DOI: 10.1016/j.survophthal.2018.05.002 -
British Dental Journal May 2020
Topics: Povidone-Iodine
PubMed: 32385428
DOI: 10.1038/s41415-020-1589-4 -
Clinical & Experimental Optometry Apr 2021Adenoviral conjunctivitis is the most common cause of ocular viral infection in the world, but currently has no approved therapeutic treatments. The antiseptic... (Review)
Review
Adenoviral conjunctivitis is the most common cause of ocular viral infection in the world, but currently has no approved therapeutic treatments. The antiseptic povidone-iodine (PVP-I) has been used as an off-label treatment for the condition, but high-quality evidence for its use is limited. This paper aims to review the literature surrounding the use of PVP-I in the management of adenoviral conjunctivitis. Unfortunately, treatment regimens, inclusion criteria, outcome measures, and review periods vary widely between studies, making direct comparisons between outcomes difficult. The majority of studies investigate daily instillation of 0.4 to 2.0% PVP-I rather than one-time instillation of PVP-I as has been used anecdotally in practice. In addition, only one treatment arm investigates daily PVP-I alone, with no significant difference in the duration of disease or clinical outcome compared to placebo. All other treatment arms investigate PVP-I in combination with dexamethasone which generally improve outcomes. Tolerability of PVP-I is generally good for low concentrations <1.0%, but efficacy of treatment is generally reported to be concentration dependent. Future research should investigate the optimal concentration, dosing regimen and role of each agent in combination treatment and aim to use laboratory techniques to improve diagnosis and provide quantifiable outcomes.
Topics: Anti-Infective Agents, Local; Conjunctivitis; Glucocorticoids; Humans; Povidone-Iodine; Treatment Outcome
PubMed: 33689609
DOI: 10.1080/08164622.2021.1877532 -
Journal of Wound Care Apr 2021In this review and meta-analysis, we analyse the evidence to compare the efficacy of honey and povidone iodine-based dressings on the outcome of wound healing. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
In this review and meta-analysis, we analyse the evidence to compare the efficacy of honey and povidone iodine-based dressings on the outcome of wound healing.
METHOD
A systematic literature search was performed using PRISMA guidelines in academic databases including MEDLINE, Scopus, Embase and CENTRAL. A meta-analysis was carried out to assess the effect of honey and povidone iodine-based dressings on mean healing duration, mean hospital stay duration and visual analogue scale (VAS) score of pain.
RESULTS
From the search, 12 manuscripts with a total of 1236 participants (mean age: 40.7±11.7 years) were included. The honey-based dressings demonstrated a medium-to-large effect in reduction of mean healing duration (Hedge's g: -0.81), length of hospital stay (-3.1) and VAS score (-1.2) as compared with the povidone iodine-based dressings. We present evidence (level 1b) in favour of using honey for improvement of wound recovery as compared with povidone iodine.
CONCLUSION
This review and meta-analysis demonstrate beneficial effects of honey-based dressings over povidone iodine-based dressings for wound recovery.
Topics: Adult; Anti-Bacterial Agents; Bandages; Honey; Humans; Middle Aged; Povidone-Iodine; Wound Healing
PubMed: 33856925
DOI: 10.12968/jowc.2021.30.Sup4.S28 -
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 -
Journal of Materials Chemistry. B Dec 2022Realizing rapid and stable bonding under humid conditions has remained a challenge in adhesion science and wound dressing. In this study, polyacrylate-based underwater...
Realizing rapid and stable bonding under humid conditions has remained a challenge in adhesion science and wound dressing. In this study, polyacrylate-based underwater tape with water-enhanced adhesion and antimicrobial performance was designed and synthesized. Good underwater adhesion performance is achieved through the reasonable selection of comonomers, among which 4-hydroxybutyl acrylate (4-HBA) and isobornyl acrylate (IBOA) provide rich hydrogen bond interactions and a rigid side chain stable structure, respectively. The former effectively increases the interface strength between the tape and the substrate, while the latter ensures that the tape can maintain a good cohesion strength under water. Besides, povidone iodine (PVP-I) as a reinforcing filler and germicidal factor endows the tape with tunable mechanical properties and impressive antimicrobial abilities. This work provides a facile approach to prepare a wet adhesive for medical and industrial fields which can be used as wound dressing and underwater adhesive materials.
Topics: Povidone-Iodine; Anti-Infective Agents
PubMed: 36448473
DOI: 10.1039/d2tb02115c -
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 -
Ear, Nose, & Throat Journal Nov 2020Approaches to nasal and oral decontamination with povidone-iodine (PVP-I) have been published to reduce nosocomial spread of Severe Acute Respiratory... (Review)
Review
OBJECTIVES
Approaches to nasal and oral decontamination with povidone-iodine (PVP-I) have been published to reduce nosocomial spread of Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2). The safety of PVP-I topically applied to the nasal and oral cavity is addressed by a literature review. The specific efficacy of PVP-I against coronaviruses and its potential efficacy against SARS-CoV-2 is discussed.
METHODS
A review was performed utilizing PubMed and Cochrane Databases. All citations in protocols for nasal and oral PVP-I use regarding COVID-19 were independently reviewed.
RESULTS
Povidone-iodine has been safely administered for up to 5 months in the nasal cavity and 6 months in the oral cavity. Concentrations less than 2.5% in vitro do not reduce ciliary beat frequency or cause pathological changes in ciliated nasal epithelium, upper respiratory, or mucosal cells. Adverse events with oral use have not been reported in conscious adults or children. Allergy and contact sensitivity is rare. Chronic mucosal use up to 5% has not been shown to result in clinical thyroid disease. PVP-I is rapidly virucidal and inactivates coronaviruses, including SARS-CoV and Middle East Respiratory Syndrome (MERS).
CONCLUSIONS
Povidone-iodine can safely be used in the nose at concentrations up to 1.25% and in the mouth at concentrations up to 2.5% for up to 5 months. Povidone-iodine rapidly inactivates coronaviruses, including SARS and MERS, when applied for as little as 15 seconds. There is optimism that PVP-I can inactivate SARS-CoV-2, but in vitro efficacy has not yet been demonstrated.
Topics: Administration, Topical; Anti-Infective Agents, Local; Betacoronavirus; COVID-19; Coronavirus; Coronavirus Infections; Disinfection; Humans; Mouth; Nasal Cavity; Pandemics; Paranasal Sinuses; Pneumonia, Viral; Povidone-Iodine; SARS-CoV-2
PubMed: 32520599
DOI: 10.1177/0145561320932318