povidone-iodine and Otitis-Media

Nowadays, povidone-iodine is commonly used as a disinfectant in head and neck procedures. The present study investigated the effect of povidone-iodine, which is used as a disinfectant solution in tympanoplasty, on patients' hearing.. A povidone-iodine solution was used as disinfection in chronic otitis media patients undergoing tympanoplasty. In the intervention group, 5% povidone-iodine, was applied to the external auditory canal and remained there for 10 minutes. In the control group, povidone-iodine was used but not allowed to enter the external auditory canal by inserting cotton wool into the canal. To evaluate the adverse effect of povidone-iodine on hearing, the bone conduction level was compared between groups at baseline and one month after exposure.. Bone conduction levels at frequencies 500 Hz, 1 kHz, 2 kHz, 3 kHz, 4 kHz and 8 kHz and mean of bone conduction level in 500 Hz, 1 kHz and 2 kHz were measured and compared respectively between intervention and control group. No significant difference was seen between bone conduction levels of above frequencies and mean frequencies before and one month after surgery. (P-value = 0.321, 0.432, 0.219, 0.489, 0.61, 0.112, 0.324 respectively).. According to the present study, currently available 5% povidone-iodine did not affect hearing and therefore, can be comfortably used for preparation and disinfection in otologic surgeries.. Valutazione della sicurezza nell’utilizzo della soluzione con iodopovidone nella timpanoplastica: studio placebo-controllo, in triplo cieco randomizzato.. Al giorno d’oggi, lo iodio-povidone è comunemente usato come disinfettante nelle procedure della testa e del collo. Il presente studio ha esaminato l’effetto del povidone-iodio, che viene utilizzato come soluzione disinfettante nella timpanoplastica, sull’udito dei pazienti.. La soluzione di iodio-povidone è stata utilizzata come disinfettante in pazienti con otite media cronica sottoposti a timpanoplastica. Nel gruppo di intervento, lo iodio povidone al 5% è stato applicato al canale uditivo esterno e vi è rimasto per dieci minuti. Nel gruppo di controllo, è stato usato iodio-povidone ma non gli è stato permesso di entrare nel canale uditivo esterno inserendo un batuffolo di cotone nel canale. Per valutare l’effetto avverso dello iodio-povidone sull’udito, è stato valutato il livello di conduzione ossea nei gruppi di trattamento, prima dell’intervento e un mese dopo l’esposizione.. Vengono misurati e confrontati i livelli di conduzione ossea a frequenze di 500 Hz (hertz), 1 kHz (kilohertz), 2 kHz, 3 kHz, 4 kHz e 8 kHz e il livello medio di conduzione ossea a 500 Hz, 1 kHz e 2 kHz rispettivamente tra gruppo di intervento e gruppo di controllo. Non è stata osservata alcuna differenza significativa tra i livelli di conduzione ossea delle singole frequenze e delle frequenze medie prima e un mese dopo l’intervento chirurgico. (Valore P = 0,321, 0,432, 0,219, 0,489, 0,61, 0,112, 0,324 rispettivamente).. Secondo il presente studio, iodio-povidone al 5% attualmente disponibile non ha diminuito l’udito e quindi può essere tranquillamente utilizzato per la preparazione e la disinfezione nella chirurgia otologica.

Topics: Bone Conduction; Ear Canal; Humans; Otitis Media; Povidone-Iodine; Tympanoplasty

To determine the efficacy of Burow's solution as an otologic preparation for the treatment of chronic ear infection.. Two studies were included: 1) a prospective clinical study and 2) a laboratory study on antibacterial and antifungal effects.. A private otology practice and a laboratory study.. Fifty-eight patients with refractory otorrhea.. Diagnosis by otoscopy, audiometry, and bacteriology.. Burow's solution was mixed in solutions with four organisms: methicillin-resistant Staphylococcus aureus, penicillin-resistant Streptococcus pneumoniae, Candida albicans, and Aspergillus. Soon after Burow's solution was mixed in the solutions with organisms, and 5, 10, and 20 minutes thereafter, the mixtures were cultured on agars. The numbers of the bacterial or fungal colonies were counted to evaluate the effect of Burow's solution.. Changes in the clinical findings of the ears, the symptom of otorrhea, and side effects were assessed.. Thirty-five (70%) of the 50 ears assessed were "cured" and 10 (20%) ears assessed were "improved." No significant side effect was observed. Regarding the laboratory study, the four organisms disappeared within 20 minutes after Burow's solution was mixed.. Burow's solution was considered to be an effective otologic preparation.

Topics: Acetates; Anti-Infective Agents, Local; Aspergillus; Candida albicans; Chronic Disease; Female; Humans; Male; Microbial Sensitivity Tests; Otitis Externa; Otitis Media; Povidone-Iodine; Prospective Studies; Staphylococcus aureus; Streptococcus pneumoniae

Primary: to compare, in vitro, the antimicrobial activity of different antiseptic agents versus quinolone drops, against the common organisms of chronic otitis media.Secondary: to examine the possible role of pH on the antimicrobial activity of the antiseptic solutions.. Three antiseptic powders (boric acid; iodine; and a 1:1 combination of these two) and four solutions (2% boric acid; 2% acetic acid; 3.25% aluminum acetate; and 5% povidone iodine) were tested against five bacteria and two fungi common in chronic otitis media, using both agar plates and the modified broth dilution method. These results were compared with the antimicrobial activity of quinolone drops.The potential role of pH of solutions was tested by reducing the acidity of the agents and repeating the broth dilution.. Of the powders, iodine, and iodine/boric acid combined, are very effective against all organisms. Boric acid powder showed moderate effectiveness against all organisms. All solutions performed poorly on the agar plates. 5% povidone iodine has good effectivity when tested with the broth dilution method. 3.25% aluminum acetate had the best activity against Pseudomonas aeruginosa.. Boric acid powder and 5% povidone iodine solution show promise for clinical use. Boric acid powder has proven clinical effectiveness. 5% povidone iodine requires further clinical research. Although very effective in vitro, iodine powder is toxic to tissues and cannot be recommended for clinical use. The pH of solutions does not seem to play a significant role in their antimicrobial activity in vitro.

Topics: Anti-Infective Agents, Local; Humans; Otitis Media; Povidone-Iodine; Pseudomonas aeruginosa; Quinolones

The aim of this single-arm prospective study was to determine the flora of the external auditory canal (EAC) in inactive chronic otitis media and evaluate the alteration of microorganisms of the EAC during tympanoplasty upon povidone-iodine antisepsis. Sixty-three patients with central tympanic membrane perforation were enrolled in the study. Preoperative swab cultures were obtained and the EAC was packed with povidone-iodine absorbed gauze. Type I tympanoplasty via a retroauricular route was performed. Cultures from the EAC were taken at the end of each operation. Isolated organisms were identified based upon microbiological, morphological, and biochemical characteristics. The most commonly isolated organisms from preoperative samples were normal commensal flora, including 73 coagulase-negative staphylococci (CNS) and 18 diphtheroid bacilli (DB). Less commonly cultured pathogenic species included four isolates of Staphylococcus aureus and three isolates of Candida albicans. No bacteria were observed in five patients. Following povidone-iodine antisepsis, 32 of the samples were negative. Eradication was statistically significant for CNS, DB and pathogen microorganism (P < 0.05). Isolated bacteria differed from those in preoperative swab cultures in eight cases. After antisepsis, diverse strains of the CNS were isolated in 13 cases and 10 patients showed no change in microbial flora. Postoperative culture demonstrated that all seven pathogenic isolates were eradicated (100 %); this selective efficacy of povidone-iodine antisepsis against pathogenic isolates was significant when compared with commensal flora (P < 0.05). These results suggest that povidone-iodine antisepsis of the EAC before tympanoplasty is an effective method for the elimination microorganisms, especially pathogenic bacteria.

Topics: Adolescent; Adult; Anti-Infective Agents, Local; Antisepsis; Bacteria; Chronic Disease; Ear Canal; Female; Humans; Male; Middle Aged; Myringoplasty; Otitis Media; Povidone-Iodine; Prospective Studies; Tympanic Membrane Perforation; Young Adult

Repeated applications of low-concentration povidone iodine (PI) combined with dexamethasone (Dex) through a tympanic membrane ventilation tube will not cause ototoxic changes in the rat.. Otitis externa (OE) and acute otitis media (AOM) are 2 of the most common otologic disorders requiring outpatient antibiotic treatment. The development of topical treatments that are easy to administer would help to limit systemic exposure to antibiotics in these patients. Topical formulations containing Dex and low-dose PI were designed to provide both antimicrobial and anti-inflammatory effects for the treatment of OE and AOM. Treatment with PI alone has shown mixed results in studies designed to determine PI. Low concentrations of PI combined with Dex should yield less ototoxicity while maintaining effectiveness.. We performed tympanostomies on rats, inserting a ventilation tube to administer 1% or 2% PI, plus 0.1% Dex over a period of 7 days. Hearing was accessed via auditory brainstem response (ABR) testing over the duration of the study and histologic analysis was performed 15 days after the initial application to determine the effect of administration of PI/Dex on middle and inner ear structures.. The preparations used in the present investigation were formulated to allow repeated applications to both the external and middle ear, without risk to hearing or equilibrium. Neither of the PI/Dex formulations tested caused pathologic changes in the ear that significantly affected equilibrium, hearing function or morphology.

Topics: Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents; Dexamethasone; Drug Delivery Systems; Male; Otitis Externa; Otitis Media; Povidone-Iodine; Rats; Rats, Sprague-Dawley; Tympanic Membrane