povidone-iodine and Respiratory-Tract-Infections

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

Gargling to wash the throat is commonly performed in Japan, and people believe that such hygienic routine, especially with gargle medicine, prevents upper respiratory tract infections (URTIs). Its effectiveness, however, has not been established by clinical trials.. Randomized controlled trial carried out in 2002-2003 winter season and analyzed in 2003 and 2004.. Healthy volunteers (387) aged 18 to 65 years.. Participants were randomly assigned to water gargling, povidone-iodine gargling, and usual care (control). Subjects in the two gargling groups were requested to gargle with water or diluted povidone-iodine at least three times a day. Participants were followed for 60 days.. The primary outcome measure was first URTI incidence. Severity of URTI symptoms among incident cases was also evaluated. Both outcomes were assessed with a self-administered symptom record. Analyses were performed on an intention-to-treat basis.. A total of 130 participants contracted URTIs. The incidence rate of first URTI was 0.26 episodes/30 person-days among control subjects. The rate decreased to 0.17 episodes/30 person-days in the water gargling group, and 0.24 episodes/30 person-days in the povidone-iodine gargling group. Respective incidence rate ratios against controls were 0.64 (95% confidence interval [CI]=0.41-0.99) and 0.89 (95% CI=0.60-1.33). A Cox regression (proportional hazard model) revealed the efficacy of water gargling (hazard ratio=0.60, 95% CI=0.39-0.95). Even when a URTI occurred, water gargling tended to attenuate bronchial symptoms (p=0.055).. Simple water gargling was effective to prevent URTIs among healthy people. This virtually cost-free modality would appreciably benefit the general population.

Topics: Adolescent; Adult; Aged; Anti-Infective Agents, Local; Female; Humans; Male; Middle Aged; Mouthwashes; Povidone-Iodine; Respiratory Tract Infections; Water

This study was conducted to evaluate the usefulness of mechanical and chemical prophylactic oral cleansing treatments for reducing potential respiratory pathogens existing in the oral cavity.. Thirty-two patients scheduled to undergo oral and maxillofacial surgery that required endotracheal anesthesia were randomly allocated to one of the two groups, the oral cleansing group (n = 16) or the noncleansing group (n = 16). Culture and polymerase chain reaction (PCR) methods were used to detect and enumerate pathogens. Oral cleansing was carried out with an electric toothbrush capable of automatically supplying and aspirating povidone-iodine solution before surgery, followed by rinsing twice a day after surgery. Cephazolin (3 g x day(-1)) was given to all patients for 5 days after surgery.. The PCR detection rates of Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Porphyromonas gingivalis in gargle samples before treatment were 87.5%, 68.8%, 53.1%, and 40.6%, respectively. Oral cleansing reduced the detection rates and numbers of methicillin-sensitive Staphylococcus species, S. pneumoniae, and H. influenzae. In contrast, there was no significant reduction of methicillin-resistant Staphylococcus species, S. pneumoniae, H. influenzae, or P. aeruginosa in subjects who underwent systemic cephazolin administration without oral cleansing.. The combination of mechanical and chemical oral cleansing resulted in a significant reduction of potential respiratory pathogens in the oral cavity.

Topics: Adult; Anesthesia; Anti-Infective Agents, Local; Antibiotic Prophylaxis; Bacteria; Colony Count, Microbial; Humans; Intubation, Intratracheal; Middle Aged; Mouth; Mouthwashes; Oral Hygiene; Postoperative Care; Povidone-Iodine; Preoperative Care; Respiratory Tract Infections; Surgery, Oral; Toothbrushing

Topics: Aerosols; Anti-Infective Agents, Local; Antiviral Agents; Centers for Disease Control and Prevention, U.S.; COVID-19; Evidence-Based Medicine; Humans; Particulate Matter; Povidone-Iodine; Respiratory Tract Infections; SARS-CoV-2; United States; Viral Load; World Health Organization

Bacterial attachment to host cells is the initial step in the pathogenesis of infection. Our studies and those of others also showed that there is a significant correlation between the attachment of bacteria to human pharyngeal epithelial cells and the occurrence of respiratory tract infections. We identified the receptor on human pharyngeal epithelial cells which mediate binding of Moraxella catarrhalis and Haemophilus influenzae. In an attempt to prevent occurrence of infections, the effects of povidone-iodine gargling on the incidence of respiratory infections were investigated. The subjects included a total of 23 adult patients, both males and females, with chronic respiratory diseases showing repeated infections. Patients were asked to gargle more than 4 times/day with povidone-iodine gargle over extended periods of time, i.e. from several months up to over 2 years. The incidence of episodes of acute exacerbation of chronic respiratory infections decreased significantly when compared with that before use of povidone-iodine gargle. Episodes of infections with Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA) and H. influenzae were reduced by about 50%. Results of this study suggest that povidone-iodine gargle is effective in providing a significant reduction in the incidence of acute exacerbations of chronic respiratory disease. We assume that the colonized bacteria were destroyed and thus infection could not occur. Therefore, povidone-iodine gargle may be used in these patients as a preventive therapy. Further studies are needed to find out the mechanism of action of this drug for the prevention of respiratory tract infections.

Topics: Adult; Aged; Anti-Infective Agents, Local; Female; Haemophilus influenzae; Humans; Male; Middle Aged; Mouthwashes; Povidone-Iodine; Pseudomonas aeruginosa; Respiratory Tract Infections; Staphylococcus aureus

A procedure to prevent silent aspiration, which results in frequent respiratory infections, was conducted on elderly bed-bound nursing home patients who suffered mainly from cerebral infarction and dementia. We cleaned the mouth with povidone iodine and kept them in a sitting position for 2 hr after each meal in order to restrict respiratory bacterial infection and to prevent aspiration of gastric juices, respectively. Patients with urinary tract infections were excluded from the present protocol. During the treatment for 103 days the number of febrile days was significantly decreased in the treated group compared with the control group, probably due to minimizing of respiratory infections.

Topics: Aged; Aged, 80 and over; Bed Rest; Eating; Female; Fever; Gastroesophageal Reflux; Homes for the Aged; Humans; Inhalation; Japan; Male; Nursing Homes; Pharynx; Pneumonia, Aspiration; Posture; Povidone-Iodine; Respiratory Tract Infections

We evaluated methods to control the spread of respiratory syncytial virus (RSV) on our infants' ward during a community outbreak of RSV infection. Methods included isolation and cohorting of infected infants, strict handwashing, use of gowns, and the cohorting of staff to the ill infants. Of 123 infants studied, 36 were admitted with RSV infections. Of the remaining 87 contact infants, eight (19%) acquired nosocomial RSV disease. Three of the eight developed pneumonia and one died. Of the 43 staff members, 24 (56%) became infected and 82% were symptomatic. Four acquired repeated infections within weeks of the initial infection. Studies a year previously had revealed that 45% of contact infants and 42% of the staff had acquired nosocomial RSV infections. Thus, the employed procedures appeared to have decreased the transmission of RSV to infants but not to the staff. Staff may continue to be infected by large droplets from close contact with ill infants or by self-inoculation of contaminated secretions.

Topics: Antisepsis; Cross Infection; Disease Outbreaks; Female; Humans; Infant; Male; Nurseries, Hospital; Patient Isolation; Personnel, Hospital; Povidone-Iodine; Respiratory Syncytial Viruses; Respiratory Tract Infections; Respirovirus Infections; Risk; Visitors to Patients