Recurrent anaphylaxis caused by topical povidone‐iodine (Betadine)

Gray, Paul; Katelaris, Constance H.; Lipson, Diane

doi:10.1111/jpc.12232

Cited by 33 publications

(26 citation statements)

References 11 publications

(16 reference statements)

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“…Immediate type (type I allergy) reactions with allergen-specific IgE have been rarely described [19]. All reactions should be diagnosed by adequate test procedures (patch tests for delayed reactions and prick/intradermal tests for immediate reactions).…”

Section: Discussionmentioning

confidence: 99%

Iodinated Contrast Media and the Alleged “Iodine Allergy”: An Inexact Diagnosis Leading to Inferior Radiologic Management and Adverse Drug Reactions

Böhm

Nairz

Morelli

et al. 2017

Fortschr Röntgenstr

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ZUSAMMENFASSUNGZiel Ziel dieser Studie war die Überprüfung der Hypothese, dass die ungenaue Diagnose "Jodallergie" für Patienten unter radiologischen Routinebedingungen möglicherweise gefährlich ist. ABSTR ACTPurpose To test the hypothesis that the incomplete diagnosis "iodine allergy" is a possibly dangerous concept for patients under routine radiologic conditions. Materials and Methods 300 patients with a history of an "iodine allergy" were retrospectively screened and compared with two age-, sex-, and procedure-matched groups of patients either diagnosed with a nonspecific "iodine contrast medium (ICM) allergy" or an allergy to a specific ICM agent. For all groups, the clinical symptoms of the This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. most recent past adverse drug reaction (ADR), prophylactic actions taken for subsequent imaging, and ultimate outcome were recorded and analyzed.Results The diagnosis "iodine allergy" was not otherwise specified in 84.3 % patients. For this group, in most cases, the symptoms of the previous ADRs were not documented. In contrast, the type of ADR was undocumented in only a minority of patients in the comparison groups. In the group of patients with an "iodine allergy" the percentage of unenhanced CT scans was greater than within the other two groups (36.7 % vs. 28.7 %/18.6 %). ADRs following prophylactic measures were only observed in the "iodine allergy" group (OR of 9.24 95 % CI 1. 16 -73.45; p < 0.04).Conclusion This data confirms the hypothesis that the diagnosis "iodine allergy" is potentially dangerous and results in uncertainty in clinical management and sometimes even ineffective prophylactic measures.Key points ▪ The term "iodine allergy" is imprecise, because it designates allergies against different substance classes, such as disinfectants with complexed iodine and contrast media containing covalently bound iodine. ▪ There is a clear correlation between the exactness of the diagnosis -from the alleged "iodine allergy" to "contrast media allergy" to naming the exact culprit CM -and the quality of documentation of the symptoms. ▪ Management of patients diagnosed with "iodine allergy" was associated with uncertainty leading to unenhanced scans and sometimes unnecessary prophylactic actions. ▪ The term "iodine allergy" should be omitted, because it is potentially dangerous and can decrease the quality of radiology exams.

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Section: Discussionmentioning

confidence: 99%

Iodinated Contrast Media and the Alleged “Iodine Allergy”: An Inexact Diagnosis Leading to Inferior Radiologic Management and Adverse Drug Reactions

Böhm

Nairz

Morelli

et al. 2017

Fortschr Röntgenstr

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“…7 Though PVP-I solutions at concentrations below 2.5% have been demonstrated to be safe for routine, repeated use in the oral cavity, they are not recommended for patients with active thyroid disease, pregnancy, anaphylactic allergy, and in patients undergoing radioactive iodine therapy. [15][16][17] Therefore, it would be helpful to study alternatives to PVP-I to mitigate these contraindications to allow a broader population to seek the benefits of preprocedural oral rinsing. Hydrogen peroxide oral rinse is a popular rinse anecdotally used by dentists due to its long history of use in teeth whitening procedures.…”

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confidence: 99%

Comparison of In Vitro Inactivation of SARS CoV‐2 with Hydrogen Peroxide and Povidone‐Iodine Oral Antiseptic Rinses

Bidra

Pelletier

Westover

et al. 2020

Journal of Prosthodontics

151

167

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Purpose To evaluate the in vitro inactivation of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) with hydrogen peroxide (H2O2) and povidone‐iodine (PVP‐I) oral antiseptic rinses at clinically recommended concentrations and contact times. Materials and Methods SARS‐CoV‐2, USA‐WA1/2020 strain virus stock was prepared prior to testing by growing in Vero 76 cells. The culture media for prepared virus stock was minimum essential medium (MEM) with 2% fetal bovine serum (FBS) and 50 µg/mL gentamicin. Test compounds consisting of PVP‐I oral rinse solutions and H2O2 aqueous solutions were mixed directly with the virus solution so that the final concentration was 50% of the test compound and 50% of the virus solution. Thus PVP‐I was tested at concentrations of 0.5%, 1.25%, and 1.5%, and H2O2 was tested at 3% and 1.5% concentrations to represent clinically recommended concentrations. Ethanol and water were evaluated in parallel as standard positive and negative controls. All samples were tested at contact periods of 15 seconds and 30 seconds. Surviving virus from each sample was then quantified by standard end‐point dilution assay and the log reduction value of each compound compared to the negative control was calculated. Results After the 15‐second and 30‐second contact times, PVP‐I oral antiseptic rinse at all 3 concentrations of 0.5%, 1.25%, and 1.5% completely inactivated SARS‐CoV‐2. The H2O2 solutions at concentrations of 1.5% and 3.0% showed minimal viricidal activity after 15 seconds and 30 seconds of contact time. Conclusions SARS‐CoV‐2 virus was completely inactivated by PVP‐I oral antiseptic rinse in vitro, at the lowest concentration of 0.5 % and at the lowest contact time of 15 seconds. Hydrogen peroxide at the recommended oral rinse concentrations of 1.5% and 3.0% was minimally effective as a viricidal agent after contact times as long as 30 seconds. Therefore, preprocedural rinsing with diluted PVP‐I in the range of 0.5% to 1.5% may be preferred over hydrogen peroxide during the COVID‐19 pandemic.

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“…45 A chlorhexidine and povidone-iodine solution has been reported to cause anaphylaxis in use on both the skin and mucous membranes. 46,47 …”

Section: Figurementioning

confidence: 98%

Acute generalised exanthematous pustulosis and other severe drug eruptions from over the counter medications: A case report and review of the literature

Kline

Fischer

2015

Aust J Dermatology

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Recurrent anaphylaxis caused by topical povidone‐iodine (Betadine)

Cited by 33 publications

References 11 publications

Iodinated Contrast Media and the Alleged “Iodine Allergy”: An Inexact Diagnosis Leading to Inferior Radiologic Management and Adverse Drug Reactions

Iodinated Contrast Media and the Alleged “Iodine Allergy”: An Inexact Diagnosis Leading to Inferior Radiologic Management and Adverse Drug Reactions

Comparison of In Vitro Inactivation of SARS CoV‐2 with Hydrogen Peroxide and Povidone‐Iodine Oral Antiseptic Rinses

Acute generalised exanthematous pustulosis and other severe drug eruptions from over the counter medications: A case report and review of the literature

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