Prospective, Randomized Clinical Trial of Povidone-Iodine 1.25% Solution Versus Topical Antibiotics for Treatment of Bacterial Keratitis

Isenberg, Sherwin J.; Apt, Leonard; Valenton, Mario J.; Sharma, Savitri; Garg, Prashant; Thomas, Philip A.; Parmar, Pragya; Kaliamurthy, Jayaraman; Reyes, Juvenal; Ong, Daniel; Christenson, Peter D.; Signore, Madeline Del; Holland, Gary N.

doi:10.1016/j.ajo.2016.10.004

Cited by 38 publications

(32 citation statements)

References 29 publications

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“…Emerging resistance to many commercially available antibiotics makes the use of PVP‐I in ophthalmic solution an interesting, potential alternative for the treatment of bacterial infections of the ocular surface, especially in resource‐poor areas of the world, where new drugs to which these organisms may be susceptible will not be widely available (Isenberg et al. ). Indeed, Isenberg et al.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, Isenberg et al. () have recently shown that there was no significant difference between the effect of topical PVP‐I 1.25% and commercial topical antibiotics for treatment of bacterial keratitis in developing countries.…”

Section: Discussionmentioning

confidence: 99%

“…Isenberg et al. () have recently reported that PVP‐I 1.25% can be considered for treatment of bacterial keratitis when antibiotic treatment is not practical. More recently, Pepose et al.…”

Section: Introductionmentioning

confidence: 99%

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In vitro antimicrobial activity of a new ophthalmic solution containing povidone‐iodine 0.6% (IODIM^®)

Pinna

Donadu

Usai

et al. 2019

Acta Ophthalmologica

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Purpose To assess the in vitro antimicrobial activity of a new commercial ophthalmic solution containing povidone‐iodine 0.6% (IODIM®). Methods Staphylococcus aureus ATCC 43300, Pseudomonas aeruginosa ATCC 27853, three ocular bacterial isolates (1 S. epidermidis, 1 S. aureus, 1 P. aeruginosa) and five Candida species were used. The bacterial and fungal isolates were cultured on Columbia blood agar base plates and Sabouraud‐dextrose agar plates, respectively and incubated overnight at 37°C. Bacterial and fungal suspensions in sterile saline solution were prepared to an optical density equal to 0.5 McFarland standard (approximately 108 CFU/ml). Suspensions of the isolates were made in IODIM® solution to obtain a final concentration of 106 CFU/ml. The suspensions were then distributed in conical tubes in a final volume of 1 ml and incubated at 37°C. At different time‐points (1, 5, 10, 15, 20, 25, 30 min and 24 hr), 10 μl of each suspension was removed, seeded on Columbia blood agar base and Sabouraud‐dextrose agar plates and then incubated for 24 hr at 37°C. Positive and negative controls were included in all experiments. Results After 5‐min incubation, there was no bacterial growth on any plate. Conversely, IODIM® failed to kill the Candida isolates after 30 min’ exposure and needed 24 hr to eradicate the organisms. Conclusion IODIM® ophthalmic solution showed in vitro antimicrobial activity against S. epidermidis, S. aureus, P. aeruginosa and Candida species. Results suggest that it may be a potential candidate for the treatment of ocular surface infections and antimicrobial prophylaxis before intravitreal injections.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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In vitro antimicrobial activity of a new ophthalmic solution containing povidone‐iodine 0.6% (IODIM^®)

Pinna

Donadu

Usai

et al. 2019

Acta Ophthalmologica

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“…They can be used as adjunct therapy to treat difficult to eradicate infections, to reduce the duration of antibiotic use, and as primary treatment of infection. 7,10,11 Additionally, compared with antibiotics, PI 1.25% use has been recently reported to be noninferior as a treatment for bacterial keratitis. 7 The low cost, wide availability, and simple preparation of PI may make it useful as a primary therapy in resource-limited settings.…”

Section: Discussionmentioning

confidence: 99%

“…1 Isenberg et al recently reported using PI 1.25% as a treatment for bacterial keratitis. 7 The efficacy of variable concentrations of PI on pathologic ocular surface isolates has not, to our knowledge, been reported previously, despite the fact that concentration and frequency of use in treatment studies could affect outcomes and the perceived viability of PI in applications beyond surgical site prophylaxis. The purpose of the current study was to evaluate the killing time of various concentrations of PI using clinical isolates from corneal ulcers.…”

Section: Introductionmentioning

confidence: 87%

Povidone-iodine concentration and in vitro killing time of bacterial corneal ulcer isolates

et al. 2018

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Background-The concentration and dosing of povidone-iodine (PI) solution used in surgical site prophylaxis are variable. Prior in vitro work has demonstrated that dilute PI solutions (<1%) had greater bactericidal activity than stock solutions (10%). Studies using pathologic clinical isolates from the eye have yielded mixed results. The purpose of the current study was to evaluate the efficacy of different concentrations of PI on pathologic ocular surface isolates. Methods-We conducted an in vitro microbiology study using clinical isolates from corneal ulcers. Bacteria were recovered from trypticase soy agar with 5% sheep erythrocytes, chocolate agar, and thioglycollate broth media. A standardized concentration of each bacterial sample (1 × 10 8 cfu/ml) was exposed to various dilutions of PI. Quantitative cultures were performed to determine the number of organisms surviving PI exposure. Results-None of the isolates survived exposure to the PI 0.25% solution for 30 seconds. Micrococcus luteus and Staphylococcus aureus survived both 30-second and 1-minute exposure to PI 5% and 10%. The exposure time required to produce no growth was variable with concentrations of <0.25%. In some isolates, the 10% solution was faster than the more dilute solutions (0.1%, 0.05%). Conclusions-Our results are consistent with prior in vitro studies of PI, from nonocular sources, and suggest that PI has similar bactericidal action on pathologic bacteria from the ocular surface. In vitro exposure to dilute PI (0.25%) resulted in no growth after 30 seconds, whereas 10% and 5% solutions took longer to kill several of the isolates. Future investigations of PI use in ophthalmology as an antimicrobial agent should include the study of low-concentration PI (0.25%).

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Topical antibiotics for treating bacterial keratitis: a network meta-analysis

Ting

Henein

Bunce

et al. 2022

Cochrane Database of Systematic Reviews

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Prospective, Randomized Clinical Trial of Povidone-Iodine 1.25% Solution Versus Topical Antibiotics for Treatment of Bacterial Keratitis

Cited by 38 publications

References 29 publications

In vitro antimicrobial activity of a new ophthalmic solution containing povidone‐iodine 0.6% (IODIM^®)

In vitro antimicrobial activity of a new ophthalmic solution containing povidone‐iodine 0.6% (IODIM^®)

Povidone-iodine concentration and in vitro killing time of bacterial corneal ulcer isolates

Topical antibiotics for treating bacterial keratitis: a network meta-analysis

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Prospective, Randomized Clinical Trial of Povidone-Iodine 1.25% Solution Versus Topical Antibiotics for Treatment of Bacterial Keratitis

Cited by 38 publications

References 29 publications

In vitro antimicrobial activity of a new ophthalmic solution containing povidone‐iodine 0.6% (IODIM®)

In vitro antimicrobial activity of a new ophthalmic solution containing povidone‐iodine 0.6% (IODIM®)

Povidone-iodine concentration and in vitro killing time of bacterial corneal ulcer isolates

Topical antibiotics for treating bacterial keratitis: a network meta-analysis

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Product

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In vitro antimicrobial activity of a new ophthalmic solution containing povidone‐iodine 0.6% (IODIM^®)

In vitro antimicrobial activity of a new ophthalmic solution containing povidone‐iodine 0.6% (IODIM^®)