Povidone-iodine
Povidone-iodine (PVP-I), also known as iodopovidone, is an antiseptic used for skin disinfection before and after surgery.[1][2] It may be used both to disinfect the hands of healthcare providers and the skin of the person they are caring for.[2] It may also be used for minor wounds.[2] It may be applied to the skin as a liquid, an ointment or a powder.[2][3]
Clinical data
Betadine, Wokadine, Pyodine, others
polyvidone iodine, iodopovidone
Topical
- US: OTC / Rx-only
- none
(C6H9NO)n·xI
variable
Side effects include skin irritation and sometimes swelling.[1] If used on large wounds, kidney problems, high blood sodium, and metabolic acidosis may occur.[1] It is not recommended in women who are less than 32 weeks pregnant.[2] Frequent use is not recommended in people with thyroid problems or who are taking lithium.[2]
Povidone-iodine is a chemical complex of povidone, hydrogen iodide, and elemental iodine.[4] The recommended strength solution contains 10% Povidone, with total iodine species equaling 10,000 ppm or 1% total titratable iodine.[4] It works by releasing iodine which results in the death of a range of microorganisms.[1]
Povidone-iodine came into commercial use in 1955.[5] It is on the World Health Organization's List of Essential Medicines.[6] Povidone-iodine is available over the counter.[7] It is sold under a number of brand names including Betadine.[2]
Contraindications[edit]
PVP-I is contraindicated in people with hyperthyroidism (overactive thyroid gland) and other diseases of the thyroid, after treatment with radioiodine, and in people with dermatitis herpetiformis (Duhring's disease).[18]
Side effects[edit]
The sensitization rate to the product is 0.7%.[19]
Interactions[edit]
The iodine in PVP-I reacts with hydrogen peroxide, silver, taurolidine and proteins such as enzymes, rendering them (and itself) ineffective. It also reacts with many mercury compounds, giving the corrosive compound mercury iodide, as well as with many metals, making it unsuitable for disinfecting metal piercings.[18]
Iodine is absorbed into the body to various degrees, depending on application area and condition of the skin. As such, it interacts with diagnostic tests of the thyroid gland such as radioiodine diagnostics, as well as with various diagnostic agents used on the urine and stool, for example Guaiacum resin.[18]
History[edit]
Following the discovery of iodine by Bernard Courtois in 1811, it has been broadly used for the prevention and treatment of skin infections, as well as the treatment of wounds. Iodine has been recognized as an effective broad-spectrum bactericide, and is also effective against yeasts, molds, fungi, viruses, and protozoans. Drawbacks to its use in the form of aqueous solutions include irritation at the site of application, toxicity, and the staining of surrounding tissues. These deficiencies were overcome by the discovery and use of PVP-I, in which the iodine is carried in a complexed form and the concentration of free iodine is very low. The product thus serves as an iodophor.
PVP-I was discovered in 1955, at the Industrial Toxicology Laboratories in Philadelphia by H. A. Shelanski and M. V. Shelanski.[22] They carried out tests in vitro to demonstrate anti-bacterial activity, and found that the complex was less toxic in mice than tincture of iodine. Human clinical trials showed the product to be superior to other iodine formulations.[23]