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Povidone iodine: properties, mechanisms of action and role in infection control and staphylococcus aureus decolonization

Lepelletier, Didier, Maillard, Jean Yves, Pozzetto, Bruno and Simon, Anne 2020. Povidone iodine: properties, mechanisms of action and role in infection control and staphylococcus aureus decolonization. Antimicrobial Agents and Chemotherapy 64 (9) , e00682-20. 10.1128/AAC.00682-20

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Abstract

Nasal decolonization is an integral part of the strategies used to control and prevent the spread of methicillin-resistant Staphylococcus aureus (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. When compared to chlorhexidine and mupirocin, respectively, PVP-I 10% and 7.5% solution had rapid and superior bactericidal activity against MRSA in in vitro and ex vivo 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 pre-clinical 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 (SSI) in orthopedic surgery. Overall, these qualities of PVP-I make it a useful alternative decolonizing agent for the prevention of S. aureus infections, but additional experimental and clinical data are required to further evaluate the use of PVP-I in this setting.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Pharmacy
Publisher: American Society for Microbiology
ISSN: 0066-4804
Date of First Compliant Deposit: 8 July 2020
Date of Acceptance: 17 June 2020
Last Modified: 25 Nov 2020 15:50
URI: http://orca.cf.ac.uk/id/eprint/133239

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