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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 -
Otology & Neurotology : Official... Dec 2022Commercially available povidone-iodine solution can eliminate biofilms and persister cells rapidly in in vivo achievable concentrations without inducing ototoxicity.
HYPOTHESIS
Commercially available povidone-iodine solution can eliminate biofilms and persister cells rapidly in in vivo achievable concentrations without inducing ototoxicity.
BACKGROUND
Chronic suppurative otitis media (CSOM) is a substantial global problem. Current treatment options often induce a temporary remission without leading to a permanent cessation of symptoms secondary to the treatments' inability to eliminate persister cells. Povidone-iodine has been shown to be able to clear biofilm and planktonic cells in in vitro assays, but there are reports of ototoxic effects limiting its clinical utility.
METHODS
Bacterial and biofilm growth with quantification by spectrophotomer, murine auditory brainstem response (ABR), and distortion product otoacoustic emissions, immunohistochemistry, in vivo povidone-iodine treatment of murine CSOM, persister cell assay.
RESULTS
Commercially available 10% povidone-iodine solution is able to completely eradicate multiple clinical strains of Pseudomonas aeruginosa and Staphylococcus aureus in vitro with 10 minutes of exposure. Mice that have received a transtympanic injection of 1% povidone-iodine solution did not have significantly different auditory brainstem response or distortion product otoacoustic emission results compared with the control. Mice that received a povidone-iodine scrub or 10% povidone-iodine solution had significantly worsened hearing (25- and 13-dB increase in threshold, respectively; p < 0.05). In vivo CSOM infection recurred in all mice after the completion of treatment with 10% povidone-iodine solution, and there was no improvement in the bacterial load after treatment, indicating in vivo failure of therapy.
CONCLUSION
Povidone-iodine solution is effective at eliminating biofilm and persister cells in vitro at in vivo achievable concentrations but fails in vivo most likely because of kinetics of distribution in vivo. Even if drug distribution could be improved, the therapeutic window is likely to be too small given that the diluted solution does not have ototoxic potential, whereas while the scrub variant, which contains detergents, and the undiluted solution are ototoxic after a single treatment.
Topics: Mice; Animals; Povidone-Iodine; Otitis Media, Suppurative; Anti-Infective Agents, Local; Ototoxicity; Neoplasm Recurrence, Local
PubMed: 36240734
DOI: 10.1097/MAO.0000000000003726 -
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 -
Antimicrobial Resistance and Infection... Nov 2022Reports are available on cross-resistance between antibiotics and biocides. We evaluated the effect of povidone-iodine (PVP-I) and propanol-based mecetronium ethyl...
BACKGROUND
Reports are available on cross-resistance between antibiotics and biocides. We evaluated the effect of povidone-iodine (PVP-I) and propanol-based mecetronium ethyl sulphate (PBM) on resistance development, antibiotics cross-resistance, and virulence in Staphylococcus aureus.
METHODS
The minimum inhibitory concentration (MIC) of PVP-I and PBM were determined against S. aureus ATCC 25923 using the agar-dilution method. Staphylococcus aureus ATCC 25923 was subjected to subinhibitory concentrations of the tested biocides in ten consecutive passages followed by five passages in a biocide-free medium; MIC was determined after each passage and after the fifth passage in the biocide-free medium. The developed resistant mutant was tested for cross-resistance to different antibiotics using Kirby-Bauer disk diffusion method. Antibiotic susceptibility profiles as well as biocides' MIC were determined for 97 clinical S. aureus isolates. Isolates were categorized into susceptible and resistant to the tested biocides based on MIC distribution pattern. The virulence of the biocide-resistant mutant and the effect of subinhibitory concentrations of biocides on virulence (biofilm formation, hemolysin activity, and expression of virulence-related genes) were tested.
RESULTS
PVP-I and PBM MIC were 5000 μg/mL and 664 μg/mL. No resistance developed to PVP-I but a 128-fold increase in PBM MIC was recorded, by repeated exposure. The developed PBM-resistant mutant acquired resistance to penicillin, cefoxitin, and ciprofloxacin. No clinical isolates were PVP-I-resistant while 48.5% were PBM-resistant. PBM-resistant isolates were more significantly detected among multidrug-resistant isolates. PVP-I subinhibitory concentrations (¼ and ½ of MIC) completely inhibited biofilm formation and significantly reduced hemolysin activity (7% and 0.28%, respectively). However, subinhibitory concentrations of PBM caused moderate reduction in biofilm activity and non-significant reduction in hemolysin activity. The ½ MIC of PVP-I significantly reduced the expression of hla, ebps, eno, fib, icaA, and icaD genes. The virulence of the biocide-resistant mutant was similar to that of parent strain.
CONCLUSION
PVP-I is a highly recommended antiseptic for use in healthcare settings to control the evolution of high-risk clones. Exposure to PVP-I causes no resistance-development risk in S. aureus, with virulence inhibition by subinhibitory concentrations. Also, special protocols need to be followed during PBM use in hospitals to avoid the selection of resistant strains.
Topics: Humans; Staphylococcus aureus; Povidone-Iodine; Anti-Bacterial Agents; Virulence; 1-Propanol; Hemolysin Proteins; Drug Resistance, Bacterial; Staphylococcal Infections; Disinfectants
PubMed: 36369050
DOI: 10.1186/s13756-022-01178-9 -
BMC Microbiology Nov 2023The vaginal microbiome is a dynamic community of microorganisms in the vagina. Its alteration may be influenced by multiple factors, including gestational status,...
BACKGROUND
The vaginal microbiome is a dynamic community of microorganisms in the vagina. Its alteration may be influenced by multiple factors, including gestational status, menstrual cycle, sexual intercourse, hormone levels, hormonal contraceptives, and vaginal drug administration. Povidone iodine has been used before delivery to reduce infection that may be caused by the ascendance of pathogenic and opportunistic bacteria from the vagina to the uterus. This study aimed to elucidate the impact of povidone iodine use during delivery on the vaginal microbiome.
METHODS
This study enrolled a total of 67 women from maternity services in three hospitals. During the delivery process, we have applied povidone iodine in three doses such as low dose, medium dose, and high dose based on the amount of povidone iodine administered, thus, we studied the three groups of women based on the doses applied. Vaginal swab samples were collected both before and immediately after delivery, and the microbial communities were characterized using 16 S rRNA sequencing. The identification of differentially abundant microbial taxa was performed using ZicoSeq software.
RESULTS
Before delivery, the vaginal microbiome was dominated by the genus Lactobacillus, with different percentage observed (86.06%, 85.24%, and 73.42% for the low, medium, and high dose groups, respectively). After delivery, the vaginal microbial community was restructured, with a significant decrease in the relative abundance of Lactobacillus in all three groups (68.06%, 50.08%, and 25.89%), and a significant increase in alpha diversity across all 3 groups (P < 0.01). Furthermore, as the dose of povidone iodine used during delivery increased, there was a corresponding decrease in the relative abundance of Lactobacillus (P < 0.01). Contrary, there was an increase in microbial diversity and the relative abundances of Pseudomonas (0.13%, 0.26%, and 13.04%, P < 0.01) and Ralstonia (0.01%, 0.02%, and 16.07%, P < 0.01) across the groups. Notably, some functional metabolic pathways related to sugar degradation were observed to have significant change with increasing use of povidone iodine.
CONCLUSION
Povidone iodine was associated with the vaginal microbiome alterations after parturition, and its significant change was associated to the dosage of povidone iodine administered. The escalation in iodine dosage was linked to a decrease in Lactobacilli abundance, and elevated prevalence of Pseudomonas and Ralstonia. There is a need for longitudinal studies to clearly understanding the effect of povidone iodine use on maternal and infant microbiome.
Topics: Female; Humans; Pregnancy; Povidone-Iodine; Vagina; Microbiota; Bacteria; Menstrual Cycle; RNA, Ribosomal, 16S
PubMed: 37978422
DOI: 10.1186/s12866-023-03014-5 -
Medical Science Monitor : International... Dec 2020Surgical site infection (SSI) occurs at the incisional site of a surgical procedure and usually involves the skin. The use of antibacterial courses to manage SSIs is... (Review)
Review
Surgical site infection (SSI) occurs at the incisional site of a surgical procedure and usually involves the skin. The use of antibacterial courses to manage SSIs is still very challenging in clinical settings. When not used appropriately, antibacterial agents can lead to increased rates of adverse events. However, various antibacterial agents that can destroy the growth of bacteria are now available. This article aims to discuss the role of preoperative intranasal decolonization with topical povidone-iodine antiseptic in the incidence of SSI based on a review of the literature. Topical bactericidal agents can be administered intranasally before surgery to eliminate potentially harmful bacteria, including antibiotic-resistant strains of bacteria. Therefore, a few studies have recommended the use of intranasal povidone-iodine solution in the clinical setting; however, it also appears to be a promising antiseptic regimen for preoperative decontamination in patients planned to undergo surgery. Povidone-iodine is a commonly used medical antiseptic agent that is used by surgeons to promote wound healing and prevent postoperative bacterial infections. Chlorhexidine gluconate is both an antiseptic and a disinfectant, which is used to clean the skin and surgical instruments. Our review of the literature on studies on the effectiveness of intranasal povidone-iodine in the reduction of intranasal bacterial colonization and the prevention of SSI identified only 5 controlled clinical studies. One study, however, showed increased effectiveness in preventing SSI when topical intranasal povidone-iodine was combined with the use of chlorhexidine gluconate washcloths. Further large-scale controlled clinical studies are needed before proper guidelines can be made.
Topics: Administration, Intranasal; Administration, Topical; Anti-Infective Agents, Local; Antibiotic Prophylaxis; Humans; Incidence; Povidone-Iodine; Surgical Wound Infection
PubMed: 33303729
DOI: 10.12659/MSM.927052 -
Enfermedades Infecciosas Y... Mar 2023Povidone-iodine and hydrogen peroxide could be effective in against SARS-CoV-2. (Clinical Trial)
Clinical Trial
INTRODUCTION
Povidone-iodine and hydrogen peroxide could be effective in against SARS-CoV-2.
METHODS
A "non-interventional trial" in 88 patients (43±17 yrs., 55% men) with SARS-CoV-2 in nasopharyngeal swabs (RT-PCR). 31 received mouth rinses/gargling with povidone-iodine (every 8h, two consecutive days), 17 with mouth rinses/gargling of hydrogen peroxide, and 40 controls. Were repeated PCR in 3, 11 and 17 days.
RESULTS
After intervention the viral load (Log10 copies/ml) remained similar in povidone-iodine (4.3±2.7 copies/ml), hydrogen peroxide (4.6±2.9 copies/ml; p=0.40) and controls (4.4±3.0 copies/ml). The percentage of patients with a negative result in the second PCR was 27% in povidone-iodine group, 23% in hydrogen peroxide and 32% in controls; in the third PCR, 62%, 54% y 58% respectively; and in the fourth PCR, 81%, 75% y 81%.
CONCLUSION
Our results do not support the clinical usefulness of mouth rinses/gargling with povidone-iodine or hydrogen peroxide in patients with COVID-19.
Topics: Female; Humans; Male; Anti-Infective Agents, Local; COVID-19; Hydrogen Peroxide; Mouthwashes; Povidone-Iodine; SARS-CoV-2
PubMed: 36058840
DOI: 10.1016/j.eimce.2022.08.003 -
Dermatology (Basel, Switzerland) 2017Antiseptics, with a broader spectrum of antimicrobial efficacy, lower risk of antibiotic resistance development, and minimal collateral damage to host tissues, are... (Review)
Review
Antiseptics, with a broader spectrum of antimicrobial efficacy, lower risk of antibiotic resistance development, and minimal collateral damage to host tissues, are important alternatives to control the bioburden in wounds. Povidone iodine (PVP-I), in use for several decades, has the broadest spectrum of activity, a persistent antimicrobial effect, an ability to penetrate biofilms, and a lack of acquired or cross-resistance. It demonstrates good skin tolerance and low cytotoxicity. However, some reports on PVP-I have raised concerns over allergy, ineffective penetration, and toxic effects on host cells. The majority of these concerns are based on in vitro or rodent wound studies with diverse study designs and outcomes; these results may not be directly applicable in the clinical reality in humans. In this paper, we discuss the efficacy and safety of PVP-I and outline its place in wound healing in Asia, based on an appraisal of recent literature and clinical practice across the region.
Topics: Anti-Infective Agents, Local; Asia; Consensus; Drug Resistance, Bacterial; Humans; Povidone-Iodine; Wound Healing; Wound Infection; Wounds and Injuries
PubMed: 28848111
DOI: 10.1159/000479150 -
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 -
Medical Science Monitor : International... Jul 2020BACKGROUND The management of chronic unilateral hematuria (CUH) caused by benign lesions is a therapeutic challenge to many urologists. The aims of this study were to...
BACKGROUND The management of chronic unilateral hematuria (CUH) caused by benign lesions is a therapeutic challenge to many urologists. The aims of this study were to evaluate the efficacy and safety of povidone iodine sclerotherapy for CUH. MATERIAL AND METHODS We identified 20 patients who underwent povidone iodine sclerotherapy to treat CUH between September 2013 and August 2017. Radiologic and hematologic tests were normal, no definite cause of hematuria was revealed, and the malignant lesions were excluded. Cystoscopy and ureteroscopy indicated the lesions were located in the renal pelvis. The goal of successful treatment was no recurrence of hematuria during follow-up. RESULTS The present study analyzed 20 patients (9 females and 11 males), 24-73 years old (mean age 44.6) with mean follow-up of 23.8 (range 13-60) months. Endoscopic findings included discrete lesions, diffuse lesions, and no obvious lesion. Discrete lesions were identified as hemangioma (4/20, 20%), minute venous rupture (12/20, 60%), and varix (1/20, 5%). Diffuse lesions were founded via ureteroscopy in 2 (2/20, 10%) patients. In the remaining 1 (1/20, 5%) patient, no obvious lesion was found. All patients with CUH were treated with 0.5% povidone iodine for pelvicalyceal system instillation, which was given at 12-h intervals for 3 days. Only 1 patient experienced recurrent gross hematuria, after 24 months postoperatively. The overall success rate, defined as resolution of gross hematuria after povidone iodine sclerotherapy, was 95%. No complications were recorded. CONCLUSIONS The present study indicates that povidone iodine sclerotherapy could be an effective, safe, and minimally invasive treatment for chronic unilateral hematuria caused by benign lesions.
Topics: Adult; Aged; Chronic Disease; Female; Hematuria; Humans; Kidney Pelvis; Male; Middle Aged; Povidone-Iodine; Sclerotherapy; Ureteroscopy
PubMed: 32691750
DOI: 10.12659/MSM.923552