povidone-iodine and Chlamydia-Infections

To investigate if a second drop of 2.5% povidone-iodine ophthalmic solution placed within the first postnatal day would achieve better prophylaxis against ophthalmia neonatorum than a single drop applied at birth.. A masked, prospective, controlled trial was conducted over a 2 year period in a Kenyan hospital. Randomisation was achieved by alternating weeks of one or two eye drop application to both eyes. All 719 neonates received one drop of the povidone-iodine solution to both eyes at birth, while 317 received a second drop at hospital discharge or 24 (SD 4) hours after delivery, whichever was first. All infants developing conjunctivitis within a month after birth underwent microbiological analysis using Gram and Giemsa stains, direct fluorescent antibody assay for Chlamydia trachomatis, and culture.. Of the neonates receiving the one eye drop application, 18.4% returned with a red eye with discharge, 4.0% had organisms found on the initial smear, and 8.2% had a positive culture. The corresponding proportions for the multidrop group were 24.3%, 4.7%, and 10.4%. Of those returning with an inflamed eye, there were no cases of Neisseria gonorrhoeae, 4.2% in the single dose group and 3.9% in the double dose group were positive for C trachomatis, and 5.4% and 6.5% respectively for Staphylococcus aureus. At discharge, the eyelid oedema score of the double dose group was mildly greater than the single dose group (1.4 (0.67) v 1.2 (0.73), p=0.0002). There was no statistically significant difference between the groups in any other category.. There is no advantage to administering povidone-iodine prophylaxis against ophthalmia neonatorum twice in the first postnatal day over a single application at birth.

Topics: Anti-Infective Agents, Local; Chlamydia Infections; Developing Countries; Drug Administration Schedule; Edema; Eyelid Diseases; Female; Fluorescent Antibody Technique, Direct; Humans; Infant, Newborn; Kenya; Male; Ophthalmia Neonatorum; Ophthalmic Solutions; Povidone-Iodine; Prospective Studies

Bacterial vaginosis is a frequent dysbiosis, where the normal lactobacillus-dominated flora is replaced by an anaerob/aerob polymicrobial flora. Bacterial vaginosis increases the risk of acquiring sexually transmitted infections (STI) including the most frequent Chlamydia trachomatis infections. Intravaginal antiseptics are part of the bacterial vaginosis treatment, and ideally they should also inhibit the bacterial vaginosis-related STI. Therefore, we tested the antichlamydial activity of four antiseptics: iodine aqueous solution, povidone-iodine, chlorhexidine and borax. First, we measured the impact of antiseptics on the viability of the HeLa cervical epithelial cells, and calculated the maximum nontoxic concentrations. Next, we infected the cells with C. trachomatis preincubated for 1 h with the particular antiseptic. The chlamydial growth was measured by direct quantitative PCR (qPCR) of the infected cells. The minimal inhibitory concentrations (MIC) of chlorhexidine and povidone-iodine were 3·91 and 97 μg ml(-1) respectively; however, the MIC of chlorhexidine was close to its maximum nontoxic concentration. The iodine aqueous solution and the borax showed no antichlamydial activity. Our in vitro studies showed that chlorhexidine and particularly povidone-iodine are potentially able to limit the bacterial vaginosis-related C. trachomatis infection.. We measured the antichlamydial effects of various antiseptics. These antiseptics are being used for the treatment of bacterial vaginosis, but their effect on the bacterial vaginosis-related sexually transmitted infections, particularly the most frequent Chlamydia trachomatis (C. trachomatis) infections has not been investigated. We showed that povidone-iodine (Betadine) inhibited the chlamydial growth in concentrations that was not toxic to the epithelial cells. We concluded that due to its additional antichlamydial effect, povidone-iodine could be a preferable antiseptic in bacterial vaginosis treatment.

Topics: Anti-Infective Agents, Local; Cell Line; Chlamydia Infections; Chlamydia trachomatis; Chlorhexidine; Female; HeLa Cells; Humans; Microbial Sensitivity Tests; Povidone-Iodine; Vaginosis, Bacterial

The recommendations for the 2010 Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines in regard to diagnosis and treatment of gonococcal and Chlamydia trachomatis infections in infants and children are essentially the same as the 2006 guidelines. There are no new data on the diagnosis or treatment of neonatal chlamydial or gonococcal infections. New data on the efficacy of neonatal ocular prophylaxis are limited. Two recent studies from Iran and Brazil suggest that povidone-iodine may not be effective for prevention of chlamydial or gonococcal ophthalmia. Prenatal screening and treatment of pregnant women, which has been demonstrated to be very effective for the prevention of neonatal gonococcal ophthalmia, is the most effective strategy for preventing neonatal chlamydial infection.

Topics: Anti-Infective Agents; Chemoprevention; Child; Child, Preschool; Chlamydia Infections; Chlamydia trachomatis; Eye Infections; Female; Gonorrhea; Humans; Infant; Infant, Newborn; Neisseria gonorrhoeae; Povidone-Iodine; Practice Guidelines as Topic; Pregnancy; Pregnancy Complications, Infectious

During the 20th century, silver nitrate (SN) eye drops instillation to newborns had been the best prophylaxis against ophthalmia neonatorum (ON) caused by Neisseria gonorrheae, the most frequent cause of ocular infections leading to blindness. At present, this treatment has been questioned because there is a growing prevalence of other pathogens such as Chlamydia trachomatis, and SN is associated with chemical conjunctivitis (ChC). In addition, SN could present some conservation problems in tropical climates. Among other alternative drugs, 2.5% povidone-iodine has a proven efficacy, not only against Neisseria, but also against Chlamydia, has no conservation problems, has not been associated with ChC and is cheap.. The recently created Setor de Farmacovigilãncia (SF) of the São Paulo State in Brazil has created a pharmacovigilance network of 11 big public hospitals. During a periodical signal searching process, the SF found a cluster of 33 ChC reports from one of the network hospitals.. The problem was discussed with the remaining participant hospitals and this signal was used as a way to strengthen the network. Thirteen months later, 622 ChC reports were received from six hospitals.. Thus, this well-known side-effect in the literature was highlighted as a 'real' problem in Brazil, and some participant hospitals began a discussion period together with the delivery and newborn care professionals in order to switch SN by povidone-iodine. This is an example of both, how a simple pharmacovigilance exercise could improve the implication of health professionals with their own therapeutic problems and how a pharmacovigilance network could be strengthened.

Topics: Anti-Infective Agents, Local; Brazil; Chlamydia Infections; Chlamydia trachomatis; Conjunctivitis; Female; Follow-Up Studies; Hospitals; Humans; Infant, Newborn; Male; Ophthalmia Neonatorum; Ophthalmic Solutions; Povidone-Iodine; Product Surveillance, Postmarketing; Silver Nitrate

The microbicidal action spectrum of povidone-iodine (PVP-I) is broad - even after short onset times. Unlike local antibiotics and other antiseptic substances, no resistance develops. The high degree of bactericidal efficiency in respect of highly resistant gram-positive pathogenic micro-organisms, such as methicillin-resistant Staphylococcus aureus (MRSA) and enterococcus strains, is particularly significant for hospital hygiene. An in vitro study with 10 genotypically different MRSA isolates showed an optimum bactericidal effect (logarithmic reduction factor value >5) without protein load after just 30 s exposure and even in a dilution of Betaisodona solution (Mundipharma GmbH) of 1%. With protein load (0.2% albumin), the optimum in microbicidal effectiveness shifts to concentrations > or = 10% Betaisodona solution referring to an exposure time of 30 s. Since recent results are now also available on the toxicological safety of PVP-I preparations for the ciliated epithelium of the nasal mucosa and the good tolerability on skin and other mucous membranes is a known factor, a controlled clinical study is currently being carried out to eliminate colonizations of MRSA. Evidence has also recently been produced of the antiviral activity of PVP-I against herpes simplex, adeno- and enteroviruses, as well as its high degree of efficiency against Chlamydia. Hence alongside the classical fields of application, such as the disinfection of the skin and hands, mucosa antisepsis and wound treatment, there are also useful indications for the substance, i.e. rinsing of body cavities and joints and application to the eye.

Topics: Adenoviridae Infections; Anti-Infective Agents, Local; Chlamydia Infections; Cross Infection; Enterococcus; Eye Diseases; Herpes Simplex; Humans; Methicillin Resistance; Povidone-Iodine; Staphylococcus aureus

Topics: Animals; Chick Embryo; Chlamydia Infections; Chlamydia trachomatis; Kinetics; Povidone; Povidone-Iodine; Time Factors