New Aspects of the Tolerance of the Antiseptic Povidone-Iodine in Different ex vivo Models

Abstract

Investigating new possibilities for the application of 1% (v/v) iodophors, povidone-iodine (PVP-I) was better tolerated in the HET-CAM or explant test than 1% (w/v) silver nitrate or tetracycline. After application to the eye, at least 2.6% of used iodine were adsorbed. Therefore PVP-I is more effective than silver nitrate or erythromycin, meaning a possible alternative for the prevention of ophthalmia neonatorum. PVP-I is more active against methicillin-resistant Staphylococcus aureus (MRSA) in a human ex vivo skin model, which results in a complete eradication of S. aureus in the nasal cavity of volunteers after 2 daily applications and will be better tolerated by human nasal cilial epithelium than chlorhexidine. Having the same clinical tolerance as mupirocin, PVP-I is a useful alternative for the antiseptic therapy of germ carriers of MRSA. The synthesis of proteoglycans in articular cartilage of bovine sesamoid bones was increased after application of 5% (v/v) PVP-I without any increase in catabolism revealing possibilities for the use as irrigation solution in the joint.

A Clinical Study on the Tolerability of a Liposomal Povidone-Iodine Nasal Spray: Implications for Further Development

“…This is in good agreement with the aforementioned in vitro observation that liposomal PVP-I is well tolerated in sensitive tissue [13,24] . The established allergic sensitization against seasonal grass pollen of some subjects played a major role in this study.…”

“…By treating infections or preventing their development PVP-I is providing secondary wound healing support [22,23] . Moreover, the liposomal formulation of PVP-I reduces cytotoxicity [24] and has been shown to promote wound healing in animal models [12] and in clinical studies [13] . Due to this established antiseptic property, PVP-I in conventional formulations has been used occasionally and successfully for nasal application, although neither the formulation nor the application mode were optimized for the nose [25,26] .…”

“…The data could be combined with the existing data of liposomal PVP-I on local tolerance and usefulness in moist wound healing combined with antisepsis [13] . The data suggest that the optimal PVP-I concentration is between 2.2 and 4.4%, since both concentrations scored best in different tests.…”

“…Liposomal PVP-I formulation possesses additional advantages with respect to tolerability and antiseptic efficacy, as shown in cell cultures, animal studies and (as a hydrogel) in wound healing studies in man [12,13] . Liposomes are vesicles of phospholipid bilayers and water.…”

Systemic Iodine Absorption after Preoperative Antisepsis Using Povidone-Iodine in Cataract Surgery – An Open Controlled Study

“…In vitro, PVP-I diluted down to 0.125% is still microbicidally effective (>5 log CFU reduction) [13]. In rats, on the other hand, the healing of skin wounds is significantly delayed by 2% PVP-I [14], while 1.25% is tolerated in vitro by sensitive tissues such as nasociliary epithelium [15] and cartilage [16]. In the hen egg test on the chorioallantoic membrane, PVP-I 2.5% was shown to be irritative, but at a concentration of 1% was tolerated without reaction [17].…”