povidone-iodine and Eye-Diseases

To determine the effect of face washing with soap and water and cleaning with povidone iodine and cetrimide/chlorhexidine gluconate (Savlon) on upper-lid bacteria.. Prospective, nonrandomized clinical trial.. Eighty patients attending the Eye Clinic, University College Hospital, Ibadan, Nigeria.. Eighty patients assigned to 4 groups had swabs of the upper eyelid skin taken before and after face wash with soap and water, and cleansing with Savlon and 5% povidone iodine. Specimens were cultured and Gram stained. Bacterial counts were carried out using standard techniques.. Face washing with soap and water increased the proportion of patients with bacterial isolates from 80.0% to 87.5%. The average colony count increased from 187.1 to 318.5 colony units per mL (p = 0.02). Application of 5% povidone iodine without face washing with soap and water reduced the proportion of patients with bacterial isolates from 82.6% (mean count 196.5) to 28.6% (mean count 34.1)(p = 0.001); in comparison, the application of 5% povidone iodine after face washing with soap and water reduced the proportion from 71.4% (mean count 133.9) to 40.0% (mean count 69.0)(p = 0.01). Application of Savlon without face washing with soap and water reduced the proportion of patients with bacterial isolates from 100% (mean count 310.9) to 41.2% (mean count 19.8)(p = 0.004) compared with the application after face washing, which reduced the proportion from 89.5% (mean count 240.3) to 41.2% (mean count 82.9)(p = 0.02).. Both povidone and Savlon are effective in reducing periocular bacteria in an African setting. Prior face washing with soap and water had no added benefit in reducing bacterial colony count.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Infective Agents, Local; Bacteria; Cetrimonium Compounds; Chlorhexidine; Colony Count, Microbial; Detergents; Disinfection; Drug Combinations; Eye Diseases; Eyelids; Face; Female; Humans; Male; Middle Aged; Ophthalmologic Surgical Procedures; Povidone-Iodine; Prospective Studies; Soaps; Water; Young Adult

To determine the most effective method of applying povidone iodine 5% to decrease conjunctival colonization before intravitreal injections.. Twenty-eight patients from two tertiary care centers undergoing intravitreal injection for diffuse diabetic macular edema, exudative age-related macular degeneration, venous occlusive disease, or refractory pseudophakic cystoid macular edema were prospectively randomized to two study arms. One arm received 2-3 drops of 5% povidone iodine (drops group) and the second received a 10 ml flush of the same solution (flush group). The inferior conjunctival fornix was cultured before and after antiseptic technique was performed in all patients. Three culture media, thioglycollate broth, chocolate agar and blood agar, were used for each sample.. Each study group had 14 patients. Prior to antisepsis, 22 of the 28 (78.6%) subjects had positive conjunctival cultures. 16 and 14 bacterial organisms were isolated in the first and second groups, respectively. After using 2-3 drops of 5% povidone iodine in the first study arm of patients, three of 16 (18.7% reduction) bacterial organisms were no longer isolated in thioglycollate broth media. With flush irrigation of 10 ml of 5% povidone iodine, seven of 14 (50% reduction) bacterial organisms were no longer isolated (P-value 0.07) in broth media. No difference in reduction of bacterial colonization was found on plated media (chocolate agar and blood agar).. Irrigating the conjunctival fornix with 5% povidone iodine results in greater reduction of bacterial colonization compared with drop application of the same solution. Flush irrigation may provide better protection against the risk of endophthalmitis with intravitreal injections.

Topics: Aged; Anti-Infective Agents, Local; Bacteria; Colony Count, Microbial; Conjunctiva; Eye Diseases; Female; Glucocorticoids; Humans; Injections; Male; Ophthalmic Solutions; Povidone-Iodine; Stem Cells; Therapeutic Irrigation; Treatment Outcome; Triamcinolone Acetonide; Vitreous Body

Povidone-iodine 5% solution placed on the eye immediately before ophthalmic surgery within the preoperative preparation significantly reduces the conjunctival bacterial flora. In 40 patients undergoing ophthalmic surgery, the authors compared the outpatient use of povidone-iodine for 3 days before surgery with a 3-day course of a combination antibiotic ophthalmic solution (Neosporin) placed on the other eye. All patients also received topical povidone-iodine on the operating table directly preceding surgery. Cultures taken just before preparation of the operative field showed a similar reduction of bacteria by each regimen. Cultures taken after preparation but before commencement of surgery showed a further reduction for both regimens, but more for eyes previously treated with the antibiotic (P less than 0.02). To minimize the conjunctival bacterial flora before surgery, the authors continue to recommend instillation of a broad-spectrum antibiotic for 3 days before surgery, followed by application of povidone-iodine solution to the eye immediately before surgery within the preoperative preparation.

Topics: Ambulatory Care; Bacteria; Clinical Trials as Topic; Endophthalmitis; Eye Diseases; Humans; Ophthalmic Solutions; Povidone; Povidone-Iodine; Preoperative Care; Random Allocation; Surgical Wound Infection

A 29-year-old woman was referred to our department for corneal edema after uneventful pterygium excision surgery with conjunctival autografting. She was prescribed topical dexamethasone and showed a complete response within 2 weeks of treatment. Specular microscopic examination revealed severe endothelial cell loss in the operated eye. Mild corneal haze causing a decrease in vision (20/50) was observed in long-term follow-up. This steroid-responsive complication was linked to two possible etiologies: mild toxic anterior segment syndrome or povidone-iodine (PVP-I) corneal toxicity. Surgeons should be careful during pterygium surgery to completely clear PVP-I and avoid any penetration into the anterior chamber to prevent possible serious complications. When diffuse corneal edema is encountered after pterygium surgery, intense steroid treatment should be prescribed as in the present case.

Topics: Adult; Anterior Chamber; Corneal Edema; Eye Diseases; Female; Humans; Povidone-Iodine; Pterygium

The aim of the study was to determine the antimycotic effect of selected substances, povidone iodine at various concentrations and fluconazole, on the growth and development of Colletotrichum spp., which is one of the ocular pathogens.. The materials used for the study consisted of 1-spore cultures of 4 fungal species of the genus Colletotrichum: C. dematium, C. gloeosporioides, C. acutatum, and C. coccodes. The method of poisoning culture media and the method of stippling the substance onto fungal colonies were used in the study. Different concentrations of fluconazole (1%) and povidone iodine (1%, 2% and 5%) were evaluated.. The growth of the studied fungal species was inhibited in 100% on the medium containing povidone iodine at the concentration of 1%, 2%, and 5%. After 24 h from the application of povidone iodine, a local disappearance of aerial mycelium was observed. In the case of C. coccodes, the colonies were not damaged. After 24 h from the application of fluconazole on C. dematium, C. gloeosporioides and C. acutatum colonies, slight disappearance of aerial mycelium was observed at these points. Despite dispensing the substance during the next few days, the inhibitory effect did not increase. After the application fluconazole on the C. coccodes colonies, the inhibitory effect of the preparation was not observed.. The method of stippling of a preparation onto fungal colonies is a quick and reliable method to test many pharmacological substances. One percent, 2%, and 5% povidone iodine in culture medium is fungicidal for Colletotrichum spp. One percent fluconazole in culture medium is fungistatic for Colletotrichum spp. C. coccodes reveals the highest degree of insusceptibility to antimycotic treatment.

Topics: Anti-Infective Agents, Local; Antifungal Agents; Colletotrichum; Eye Diseases; Eye Infections, Fungal; Fluconazole; Humans; Povidone-Iodine

Topics: Cephalosporins; Drug Hypersensitivity; Eye Diseases; Humans; Ophthalmic Solutions; Penicillins; Povidone-Iodine

Topics: Anti-Infective Agents, Local; Chickenpox Vaccine; Drug Prescriptions; Eye Diseases; Humans; Ophthalmic Solutions; Optometry; Povidone-Iodine; United States; Victoria

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

Propionibacterium acnes has been described as a causative agent of postoperative endophthalmitis. This gram-positive, immotile, non-spore-forming bacterium is highly pleomorphic and grows under conditions of low to no oxygen concentration. It is commonly found on the skin at the openings of sebaceous glands and on hairs. A near-symptomless postoperative endophthalmitis occurs particularly when Propionibacteria are enclosed in the capsular bag. We investigated to what extent the number of P. acnes in the conjunctival sac can be reduced by preoperative disinfection with polyvidone iodine (1%).. A total of 261 patients with intrabulbar surgery had two conjuctival swabs taken: the first immediately prior to preoperative preparation in the operating theatre, following in-patient application of antibiotic eye drops (Polymyxin-B-sulfat, Neomycinsulfat and Gramicidin in combination); the second swab was taken after disinfection with polyvidone iodine before opening the conjunctiva.. Of the 261 swabs, 60 (23%) taken prior to polyvidone iodine application were positive for Propinibacterium acnes. Following polyvidone iodine treatment, a further 5 (1.9%) remained culture-positive. After disinfection, 55 (92%) of the 60 positive swabs for Propionibacterium acnes remained culture-negative.. We concluded that a significant reduction of P. acnes can be achieved by preoperative application of polyvidone iodine (1%) (P < 0.001).

Topics: Anti-Infective Agents, Local; Antibiotic Prophylaxis; Conjunctiva; Endophthalmitis; Eye Diseases; Humans; Microbial Sensitivity Tests; Povidone-Iodine; Preoperative Care; Propionibacterium acnes; Surgical Wound Infection

In the first postoperative day, povidone-iodine ophthalmic solution prevents an increase in conjunctival bacterial colony-forming units and decreases the species compared with antibiotic. We sought to determine whether these beneficial effects of povidone-iodine could be sustained during the first postoperative week.. In 42 eyes of 35 consecutive patients, one or two drops of either a broad-spectrum antibiotic (polymyxin B sulfate-neomycin sulfate-gramicidin) or povidone-iodine 1.25% to 2.5% were placed in the treated eye or eyes at the conclusion of surgery and three times daily during the first postoperative week. Bacterial cultures were taken from both eyes at the end of surgery before instillation of either of the eyedrops and again 1 week later. Twenty-eight untreated eyes served as a control group.. During the first postoperative week, the number of colony-forming units and species increased in both treatment groups. Relative to the control group, both medications effectively reduced the mean number of colony-forming units at 1 week (P < .02), but their effects on colony-forming units did not significantly differ from each other (80 +/- 290 for the povidone-iodine-treated eyes and 75 +/- 90 for the antibiotic-treated eyes). At 1 week, the species count increased 281% in the antibiotic group but only 106% in the povidone-iodine group. Compared to the control group, eyes that received povidone-iodine had a significantly lower species count (P = .0097).. Povidone-iodine ophthalmic solution is an alternative to postoperative topical antibiotics because of its effectiveness in controlling conjunctival bacterial colony-forming units and species, its relatively low cost, and its availability.

Topics: Administration, Topical; Anti-Bacterial Agents; Anti-Infective Agents, Local; Bacteria; Colony Count, Microbial; Drug Therapy, Combination; Eye; Eye Diseases; Eye Infections, Bacterial; Humans; Ophthalmic Solutions; Postoperative Period; Povidone-Iodine; Prospective Studies; Surgical Wound Infection

Povidone-iodine 5% solution decreases the incidence of postoperative endophthalmitis when used on the eye for preoperative preparation. We sought to determine whether it also minimized conjunctival bacterial flora immediately after surgery by preventing bacteria present on the surface of the eye from entering surgical wounds.. In 42 eyes of 40 patients, at the conclusion of surgery, on an alternating basis, each patient received either a drop of a broad-spectrum antibiotic solution (polymyxin B sulfate-neomycin sulfate-gramicidin) or a 5% povidone-iodine solution in the operated-on eye. Bacterial cultures were taken before and after surgery and 24 hours later. The 38 unoperated-on eyes in the unilateral cases served as control eyes.. Relative to the control group, povidone-iodine was effective in preventing an increase in the number of colony-forming units (P = .035), while the antibiotic was not. At 24 hours after surgery, the species count was lower in the eyes receiving povidone-iodine than in the antibiotic-treated eyes (P = .034) and was increased in the antibiotic group since the completion of surgery (P = .013), but was lower in the povidone-iodine and antibiotic groups than in the control eyes for both groups (P < .01).. Povidone-iodine 5% solution applied to the eye at the conclusion of surgery was more effective at minimizing the number of colony-forming units and species for the first postoperative day than was a broad-spectrum antibiotic. While not true for the antibiotic, the antimicrobial effect of povidone-iodine lasted for at least 24 hours after the completion of surgery.

Topics: Bacteria; Colony Count, Microbial; Conjunctiva; Drug Therapy, Combination; Endophthalmitis; Eye Diseases; Eye Infections, Bacterial; Gramicidin; Humans; Neomycin; Ophthalmic Solutions; Polymyxin B; Povidone-Iodine; Surgical Wound Infection

Preoperative eyes which had been treated with gentamicin for one-half day were subjected to one of two povidone-iodine (PI) preparations. The control eye was prepared using a previously described 5% PI one-drop technique, while the paired eye was irrigated with a 0.02% PI solution. Aerobic and anaerobic bacterial cultures were taken of each eye before and after PI applications. Statistical analysis of the data indicates that both techniques were equally effective in reducing surface colonization of the anaerobic cocci and bacilli, the viridans streptococci and micrococci. Both methods were also equally ineffective in reducing the numbers of coagulase-negative staphylococci from the surface of the eye. With the apparent emergence of gentamicin-resistant coagulase-negative staphylococci the potential for staphylococcal endophthalmitis is increasing.

Topics: Colony Count, Microbial; Endophthalmitis; Eye Diseases; Humans; Military Personnel; Postoperative Complications; Povidone-Iodine; Preoperative Care; Staphylococcal Infections; Therapeutic Irrigation

In this report the possibilities for the application of PVP-iodine-preparations in the developing countries in the treatment of wounds, including burns and in diseases of the mucous membrane, eyes, mouth and genital region are discussed. The application proved particularly valuable where a high antibiotic resistance was found.

Topics: Atlantic Islands; Burns; Chemical Phenomena; Chemistry; Eye Diseases; Humans; Povidone; Povidone-Iodine; Skin Diseases, Infectious; Sudan; Surgical Wound Infection; Wound Infection; Wounds and Injuries

Topics: Eye Diseases; Humans; Iodine; Ophthalmic Solutions; Povidone; Povidone-Iodine; Premedication; Surgical Wound Infection

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Conjunctiva; Disinfection; Eye Diseases; Eyelids; Female; Humans; Male; Middle Aged; Povidone-Iodine; Skin; Sterilization

An important source of postoperative eye infection is the indigenous flora in and around the eye. Therefore, proper preparation of the operative field is crucial. Through an international survey we determined that ophthalmic surgeons used widely varying techniques in the pre-operative antimicrobial preparation of the eye. On the basis of these survey responses we have studied to date the effect on the bacterial flora of the conjunctiva of three regimens. Irrigation of the conjunctiva with saline tended to increase the ocular flora; instillation of silver protein solution had no significant effect. Povidone-iodine drops (5%) significantly reduced both colony and species counts.

Topics: Anti-Infective Agents, Local; Bacterial Infections; Conjunctiva; Eye; Eye Diseases; Humans; Microbial Sensitivity Tests; Ophthalmic Solutions; Ophthalmologic Surgical Procedures; Postoperative Complications; Povidone; Povidone-Iodine; Premedication; Silver Proteins

Topics: Animals; Antifungal Agents; Aspergillosis; Aspergillus; Candida albicans; Eye Diseases; Microbial Sensitivity Tests; Ophthalmic Solutions; Povidone; Povidone-Iodine; Rabbits; Time Factors