Povidone Iodine: Properties, Mechanisms of Action, and Role in Infection Control and Decolonization.
(2020) Antimicrobial Agents and Chemotherapy — Vol. 64, n° 9, p. e00682-20 [1-13] (2020)
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- Nasal decolonization is an integral part of the strategies used to control and prevent the spread of methicillin-resistant (MRSA) infections. The two most commonly used agents for decolonization are intranasal mupirocin 2% ointment and chlorhexidine wash, but the increasing emergence of resistance and treatment failure has underscored the need for alternative therapies. This article discusses povidone iodine (PVP-I) as an alternative decolonization agent and is based on literature reviewed during an expert's workshop on resistance and MRSA decolonization. Compared to chlorhexidine and mupirocin, respectively, PVP-I 10 and 7.5% solutions demonstrated rapid and superior bactericidal activity against MRSA in and studies. Notably, PVP-I 10 and 5% solutions were also active against both chlorhexidine-resistant and mupirocin-resistant strains, respectively. Unlike chlorhexidine and mupirocin, available reports have not observed a link between PVP-I and the induction of bacterial resistance or cross-resistance to antiseptics and antibiotics. These preclinical findings also translate into clinical decolonization, where intranasal PVP-I significantly improved the efficacy of chlorhexidine wash and was as effective as mupirocin in reducing surgical site infection in orthopedic surgery. Overall, these qualities of PVP-I make it a useful alternative decolonizing agent for the prevention of infections, but additional experimental and clinical data are required to further evaluate the use of PVP-I in this setting.
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Lepelletier, D., Maillard, J. Y., Pozzetto, B., & Simon, A. (2020). Povidone Iodine: Properties, Mechanisms of Action, and Role in Infection Control and Decolonization. Antimicrobial Agents and Chemotherapy, 64(9), e00682-20 [1-13]. https://doi.org/10.1128/AAC.00682-20 (Original work published 2020)