povidone-iodine and Herpes-Simplex

Neonatal herpes infection is secondary to pre/perinatal viral contamination from mother by HSV2 (70 p. 100) or HSV1 (30 p. 100). Incidence in French population is closed to 3/100,000 live births corresponding to 20 cases per year. Risk for maternal viral transmission to the neonate is 30 p. 100 with genital herpetic primo infection and 3 p. 100 in recurrence. However, in 70 p. 100 of cases, maternal history is not contributive. Three main clinical presentations are described However atypical symptoms - as isolated fever - can be a telltale sign. Mean clinical delay from birth to first clinical symptoms is 6 to 12 days and neonate is usually symptom - free at birth. Viral cultures from pharynx, stools, cutaneous lesions and specific PCR in blood and cerebrospinal fluid confirm the diagnosis. Curative treatment is acyclovir at high dosage - 60 mg/kg/d - during 14 days for localized forms and 21 days for neurological and disseminated diseases. Compared to conventional dosages, this treatment leads to a reduction in mortality which however remains high in disseminated forms, 31 p. 100 and 6 to 11 p. 100 in CNS infection. Morbidity is also high in survived patients, 17 p. 100 and 31 p. 100 respectively. Efficacy of prophylactic viral decontamination by anti-herpetic eye drops and cutaneous polyvidone iodine bath, which is largely used at birth in France, has never been evaluated.

Topics: Acyclovir; Anti-Infective Agents, Local; Antiviral Agents; Drug Therapy, Combination; Female; France; Herpes Simplex; Herpesvirus 1, Human; Herpesvirus 2, Human; Humans; Infant, Newborn; Infant, Newborn, Diseases; Povidone-Iodine; Pregnancy; Pregnancy Complications, Infectious

The clinical value of aciclovir, oral or topical, in the episodic treatment of recurrent herpes virus infection is limited. Betadine (povidone-iodine) could provide a cheap, effective alternative for managing symptomatic recurrences. We describe a case where povidone-iodine was used successfully to treat a recurrence of genital herpes simplex and review the literature supporting povidone-iodine in the treatment of genital tract infections.

Topics: Adult; Antiviral Agents; Female; Herpes Genitalis; Herpes Simplex; Humans; Povidone-Iodine

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: Aerosols; Double-Blind Method; Female; Herpes Simplex; Humans; Male; Povidone; Povidone-Iodine

A preliminary evaluation was carried out in 23 patients with herpes genitalis to assess the effectiveness of a 10% alcoholic povidone-iodine solution applied twice daily for up to 14 days. Clinical diagnosis was supported by positive herpes simplex virus culture in 14 patients. The lesions cleared after an average of 8.9 days' treatment in 8 males presenting with herpes genitalis for the first time, and in 6.1 days in 9 males with recurrent infection, 6 of whom had shown no apparent improvement on other therapies. The 4 female patients presenting with herpes genitalis for the first time all showed substantial improvement or complete remission within 7 days, and the lesions in the 2 women with recurrent infection cleared within the same period. In view of these satisfactory findings, a double-blind controlled study of povidone-iodine is now being undertaken.

Topics: Adult; Female; Genital Diseases, Female; Genital Diseases, Male; Herpes Simplex; Humans; Male; Povidone; Povidone-Iodine; Recurrence; Time Factors

Twenty-two patients with Herpes Simplex were treated with Betadine (povidone iodine) Antiseptic paint and seven with 5% idoxuridine in dimethyl sulphoxide, also one patient with bilateral lesions was treated with the two solutions, one on each side. The povidone iodine alcohol solution appeared to be at least as effective as the idoxuridine with minimal side-effects (some stinging in two patients). Good results were also obtained with this solution in twelve patients with Herpes Zoster.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Dimethyl Sulfoxide; Female; Herpes Simplex; Herpes Zoster; Humans; Idoxuridine; Male; Middle Aged; Povidone; Povidone-Iodine

Ten patients with vulvovaginal and cervical herpesvirus infections were treated with a regimen of external and intravaginal povidone-iodine preparations. In all but 1 case, the expected duration of symptoms and healing time were shortened. The response of cervical lesions was especially remarkable. The findings of this pilot study warrant further controlled clinical investigation.

Topics: Adult; Female; Genital Diseases, Female; Herpes Simplex; Humans; Middle Aged; Pilot Projects; Povidone; Povidone-Iodine; Uterine Cervical Diseases; Vaginal Diseases; Vulva