povidone-iodine and Mouth-Diseases

To better inform medical practitioners on the role of antiseptics in oropharyngeal health and disease, this article focuses on povidone-iodine (PVP-I), an established and widely-available antiseptic agent.. Review of the anti-infective profile, efficacy and safety of PVP-I in managing common upper respiratory tract infections such as the common cold, influenza and tonsillo-pharyngitis, as well as oral complications resulting from cancer treatment (oral mucositis), and dental conditions (periodontitis, caries).. Antiseptics with broad-spectrum anti-infective activity and low resistance potential offer an attractive option in both infection control and prevention. While there is some evidence of benefit of antiseptics in a variety of clinical settings that include dental and oral hygiene, dermatology, oncology, and pulmonology, there appears to be discordance between the evidence-base and practice. This is especially apparent in the management and prevention of oropharyngeal infections, for which the use of antiseptics varies considerably between clinical practices, and is in marked contrast to their dermal application, where they are extensively used as both a prophylaxis and a treatment of skin and wound infections, thus minimising the use of antibiotics.. The link between oral and oropharyngeal health status and susceptibility to infection has long been recognised. The high rates of antibiotic misuse and subsequent development of bacterial resistance (e.g. increasing vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA)) in large parts of the world, especially across Asia Pacific, highlight the need for identifying alternative antimicrobials that would minimise the use of these medications. This, together with recent large-scale outbreaks of, for example, avian and swine influenza virus, further underline the importance of an increasing armamentarium for infection prevention and control.

Topics: Anti-Infective Agents, Local; Bacteria; Bacterial Infections; Humans; Infection Control; Mouth Diseases; Mycoses; Povidone-Iodine; Respiratory Tract Infections; Virus Diseases

Due to the great number of different micro-organisms present, the oral cavity is an important source of infection. Infections caused by these micro-organisms can occur as local infections of the oral mucous membrane, local infections of the soft tissues or the bones following surgical intervention, or endocarditis due to bacteraemia following dental surgery. In the therapy of periodontal diseases, the application of antiseptic solutions is indicated to inhibit or reduce plaque accumulation. Povidone-iodine (PVP-I) solution will reduce inflammation and the progression of periodontal disease. The application of antiseptics in the oral mucous membrane is also indicated to prevent wound infections following surgical intervention in patients with leukaemia, AIDS, immunosuppressant therapy and patients undergoing anti-neoplastic radiation or chemotherapy. Some trials on the antibacterial efficacy of PVP-I in vivo showed reduction factors of log 2-3. PVP-I may therefore be recommended as an oral antiseptic. The irrigation of the gingival sulcus with an antiseptic solution is a useful complement to antibiotic prophylaxis in patients at risk of bacterial endocarditis. Many trials on the effectiveness of PVP-I on dental extraction bacteraemia have shown a significant benefit in the active group in comparison with the control group.

Topics: Administration, Topical; Antisepsis; Bacterial Infections; Endocarditis, Bacterial; Humans; Mouth Diseases; Periodontitis; Povidone-Iodine; Wound Infection

Fungal-bacterial interactions generate unique biofilms that cause many infections in humans. Candida albicans interact with Streptococcus mutans in dental biofilms associated with severe childhood tooth-decay, a prevalent pediatric oral disease. Current modalities are ineffective and primarily based on antimicrobial monotherapies despite the polymicrobial nature of the infection. Here, we show that the combination of clinically used topical antifungal fluconazole with povidone iodine (PI) can completely suppress C. albicans carriage and mixed-biofilm formation without increasing bacterial killing activity in vivo. We unexpectedly found that the inclusion of PI enhanced fluconazole efficacy by potently disrupting the assembly of a protective bacterial exopolysaccharide (EPS) matrix through inhibition of α-glucan synthesis by S. mutans exoenzyme (GtfB) bound on the fungal surface. Further analyses revealed that the EPS produced in situ directly bind and sequester fluconazole, reducing uptake and intracellular transportation of the drug. Conversely, inhibition of GtfB activity by PI, enzymatic degradation of the α-glucan matrix or co-culturing with gtfB-defective S. mutans re-established antifungal susceptibility. Hence, topical antifungal has limitations in mixed oral biofilms due to enhanced C. albicans tolerance to fluconazole afforded by the shielding effect of bacterial-derived EPS. The data provide new insights for treatment of C. albicans in cross-kingdom biofilms, indicating that EPS inhibitors may be required for enhanced killing efficacy and optimal anti-biofilm activity.

Topics: Animals; Anti-Bacterial Agents; Antifungal Agents; Bacterial Infections; Biofilms; Candida albicans; Drug Tolerance; Enzymes; Female; Fluconazole; Glucans; Metagenome; Mouth Diseases; Mycoses; Polysaccharides, Bacterial; Povidone-Iodine; Rats; Rats, Sprague-Dawley; Streptococcus mutans

The Betadine is an antiseptic PVP (polyvinil prrolidon)-iodine containing, water soluble solution, which has been in circulation in Hungary for years. Until now Betadine was not applied in the oral cavity for bacterial and fungal infections, although its effectiveness is unquery. The PVP-iodine is water solubilized that's why it does not sting the healthy or ill oral mucosa and has not side effects as discoloration of the teeth and tongue and trouble in the sensation of taste as does chlorhexidine. The only contraindication is iodine allergy. In the present study: in periodontal cases (abscesses, postoperative prevention) and in oral medicine cases alone or in combination with specific treatment schedule was Betadine applied. PVP-iodine as oral rinse was applied in 25 cases. According to our experience Betadine was excellent against bacterial and fungal infections in the oral cavity, which prevent or treat bacterial infections after surgical interventions. By this way the bacterial superinfections of exulcerant oral mucosal diseases avoidable.

Topics: Adult; Anti-Infective Agents, Local; Bacterial Infections; Female; Humans; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Mycoses; Oral Surgical Procedures; Periodontal Diseases; Povidone-Iodine

The results of Betadine treatment obtained in the course of a one-year period proved the usefulness of the bacteriostatic and bactericidal product as a disinfectant of the skin and mucosa in immuno-deficiency diseases, in our cases in AIDS (but supposedly in other similar diseases as well). In these diseases this new therapeutic means does supply a need. The solution was successfully used in patients in whom superficial decontamination is of high importance and whose cutaneous and mucosal infections had raised therapeutic problems for years. Side-effects were not observed. The product could be easily applied. If the germ count of the atrophying pathogen is not very high and the lesion is due supposedly to mixed infection, the product will be effective even in monotherapy. Similarly, in mild mycotic infections systemic therapy could be avoided. In cases of purulent alterations the solution is successfully applied as an adjuvant to antibacterial treatment and its continuous use prevents early recurrence. The long-term use of the product did not cause side-effects, irritation of the skin or the mucosa.

Topics: Anti-Bacterial Agents; Baths; Drug Evaluation; Drug Therapy, Combination; HIV Infections; Humans; Mouth Diseases; Oral Hygiene; Povidone-Iodine; Skin Diseases, Infectious; Solutions

Topics: Animals; Capillary Permeability; Mouth Diseases; Povidone; Povidone-Iodine

The effect of a multi-agent regimen on oropharyngeal candidiasis (OPC) prophylaxis in 16 consecutive pediatric bone marrow transplant patients was assessed. The multi-agent regimen consisted of: 1) debriding all mucous membrane surfaces within the oropharyngeal cavity with povidone-iodine 4 times a day, 2) swabbing all mucous membrane surfaces within the oropharyngeal cavity with nystatin 4 times a day, and 3) Ketoconazole given daily by mouth. Multi-agent regimen therapy was initiated on the day marrow ablative therapy began, and was terminated when the patient's absolute neutrophil count recovered to above 500/mm3. Baseline oropharyngeal fungal cultures indicated that 8 out of 16 (50%) of the patients were Candida carriers. Subsequent surveillance cultures indicated that 13 out of 16 (81.3%) of the patients had negative oropharyngeal fungal cultures during the entire period they were on the multi-agent regimen. The remaining three patients had negative oropharyngeal fungal cultures by the end of the experimental period. None of the patients developed Candida esophagitis or sepsis. The above regimen is an effective and non-toxic method to prevent oropharyngeal candidiasis in pediatric BMT patients.

Topics: Adolescent; Anemia, Aplastic; Bone Marrow Transplantation; Burkitt Lymphoma; Candidiasis; Child; Child, Preschool; Female; Humans; Infant; Ketoconazole; Leukemia; Leukemia, Lymphoid; Male; Mouth Diseases; Neuroblastoma; Nystatin; Pharyngeal Diseases; Povidone-Iodine; Transplantation, Autologous; Transplantation, Homologous

Topics: Adolescent; Aged; Coxsackievirus Infections; Diagnosis, Differential; Female; Foot Dermatoses; Hand Dermatoses; Humans; Infant; Mouth Diseases; Povidone-Iodine; Seasons; Stomatitis, Aphthous