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Hand-washing degerming: a comparison of povidone-iodine and chlorhexidine.

Two antiseptic preparations for hand washing were compared by the glove-juice method in a crossover study on 10 volunteers. The reference preparation was 7.5% povidone-iodine (Betadine Surgical Scrub); the test agent was 4% chlorhexidine gluconate combined with 4% isopropyl alcohol (Hibiclens). The experimental model included inoculation of the hands with a mixture of Serratia marcescens, Escherichia coli, Providentia stuartii, and Pseudomonas aeruginosa. The reference preparation achieved a reduction ratio in colony counts of 695 to 1 under the conditions of this study. The average postwash colony count after use of 7.5% povidone-iodine was significantly less than the preinoculation colony count. Logarithmic values, and the paired t test applied to them, showed a highly significant difference (p = less than 0.001) in favor of the degerming ability of the reference agent compared to the test agent. These data are of value in the selection of preparations for hand washing and may point the way to quantitative methods for other degerming studies.

Anti-Infective Agents, Local

Structure of polyvinylpyrrolidone-iodine (povidone-iodine).

Hydrogen triiodide adducts were prepared from N,N-dimethylacetamide, N-alkylpyrrolidone derivatives, and polyvinylpyrrolidone, and their structures were investigated by IR spectra and X-ray structure analyses and compared with the structure of povidone-iodine USP. The results suggest that the iodine in povidone-iodine USP is complexed by the polymer such that a proton is fixed via a short hydrogen bond between two carbonyl groups of two pyrrolidone rings and that a triiodide anion is bound ionically to this cation.

Chemical Phenomena

Absorption of iodine in the neonate following topical use of povidone iodine.

Topical application of povidone iodine on the umbilical cord and normal intact skin of newborn infants resulted in significantly elevated plasma iodine levels. High iodine levels were also found in two neonates who had povidone iodine applied to denuded skin. No significant alteration in thyroid function was seen. The possible toxic manifestations of high plasma iodine levels are discussed.

Administration, Topical

Prevention of wound infection in abdominal operations by peroperative antibiotics or povidone-iodine. A controlled trial.

The wound-infection rate after abdominal operations was compared in 113 patients randomly allocated to an untreated control group, a group receiving preoperative lincomycin and tobramycin, or a group receiving local instillation of povidone-iodine. The wound-infection rate was 8.1% in 37 patients receiving antibiotics, 42.1% in 38 untreated controls, and 39.5% in 38 patients in the povidone-iodine group.

Abdomen

Topical application of povidone-iodine in the management of decubitus and stasis ulcers.

The efficacy of topical applications of povidone-iodine (Betadine solution and ointment) for the control of infection associated with decubitus and stasis ulcers was evaluated in 18 male outpatients (age range, 33--68 years). Dressings were changed twice daily over a period of 42 days. Statistically significant improvement was noted in the following signs and symptoms: edema, pain, erythema, ulcer size, and ulcer depth. All patients experienced some degree of symptomatic relief and clinical improvement within two weeks after starting therapy. At the end of the study, 67 percent of the ulcers were clinically cured and 33 percent showed improvement. Acceptance by the patients was excellent, with no reported side effects or sensitization reactions. Povidone-iodine used in a daily regimen of ulcer care can reduce the level of infection and promote healing.

Administration, Topical

Lack of influence of povidone-iodine on tests of thyroid function.

The external application of povidone-iodine, an antiseptic agent, was tested for its influence on thyroid function. Previous workers have described some in vitro changes in thyroid function tests following its use. In the present study topical application of povidone-iodine did not affect thyroid function as measured some days later using both in vivo and radio-active iodine in vitro test methods, despite the fact that the latter are notorious for being influenced by exogenous iodine.

Administration, Topical

Use of a povidone-iodine alcoholic solution in the treatment of herpes genitalis: a preliminary study.

A preliminary evaluation was carried out in 23 patients with herpes genitalis to assess the effectiveness of a 10% alcoholic povidone-iodine solution applied twice daily for up to 14 days. Clinical diagnosis was supported by positive herpes simplex virus culture in 14 patients. The lesions cleared after an average of 8.9 days' treatment in 8 males presenting with herpes genitalis for the first time, and in 6.1 days in 9 males with recurrent infection, 6 of whom had shown no apparent improvement on other therapies. The 4 female patients presenting with herpes genitalis for the first time all showed substantial improvement or complete remission within 7 days, and the lesions in the 2 women with recurrent infection cleared within the same period. In view of these satisfactory findings, a double-blind controlled study of povidone-iodine is now being undertaken.

Adult

Irrigation of subcutaneous tissue with povidone-iodine solution for prevention of surgical wound infections.

Five hundred patients undergoing a variety of general surgical operative procedures were prospectively randomly allocated into a treatment group, in which the incisions were irrigated with povidone-iodine solution prior to skin closure or into a control group in which wounds were irrigated with saline solution. Wounds were classified according to the degree of bacterial contamination as clean, potentially contaminated, contaminated or dirty. For all categories of surgical incisions, povidone-iodine irrigation resulted in a significant decrease in wound infections over that for saline solution irrigation. Over-all incidence of wound sepsis in the treatment group was seven of 242 patients, 2.9 per cent, compared with the control rate of 39 wound infections of 258 patients, 15.1 per cent--p less than 0.001.

Adolescent

Development of a stable sublingual nitroglycerin tablet II: formulation and evaluation of tablets containing povidone.

Stable and pharmaceutically elegant sublingual nitroglycerin tablets were formulated using povidone to retard volatilization of the drug. Formulation and processing variables were investigated to produce an acceptable product. A blend of two grades of povidone, of different degrees of cross-linkage and water solubility, provided stable tablets which exhibited rapid disintegration. Directly compressed sublingual tablets made in this study retained over 80% of the initial nitroglycerin when exposed to the atmosphere at room temperature for 2 months. The direct compression tablets are of good appearance and low friability, and the formulation is readily compressed without problems. An interesting relationship among the hardness, disintegration time, and compaction pressure is described.

Drug Compounding

Short term metronidazole therapy contrasted with povidone-iodine spray in the prevention of wound infection after appendicectomy.

In a prospective, randomized trial metronidazole was found to be significantly better than povidone-iodine in reducing the incidence of wound infection after appendicectomy (P less than 0.005). The metronidazole was given as a established 7-day course. Over 65 per cent of the wound infections presented after the patients had been discharged from hospital.

Aerosols

Treatment of second degree burns: nitrofurazone, povidone-iodine, and silver sulfadiazine.

Nitrofurazone (N), povidone-iodine (P), and silver sulfadiazine (S) were compared in the emergency department outpatient treatment of 84 patients suffering second degree burns over less than 15% (adults) or 5% (children) of their total body surface area. Indices of healing were percent of healing, degree of dryness, crust separation, eschar separation, tissue granulation, and wound pain. Statistical analysis indicates that healing in N-treated patients was superior to that in S-treated patients: tissue granulation began sooner, crusts separated more rapidly, wounds were dryer, and the amount of healing at two weeks was greater. Results in P-treated patients were equivalent to those in N-treated when cases with complications were excluded from analysis. Among patients with less serious burns, N-treated patients suffered less pain than S-treated, but there was no significant difference in pain between N and P or between P and S. In patients with more serious second-degree burns there was more pain with P than with N, but neither P nor N differed significantly from S in this regard.

Burns

Comparing the efficacy of chlorhexidine and povidone-iodine for surgical site disinfection: a systematic review and meta-analysis from randomized controlled trials.

BACKGROUND: Randomized controlled trials report conflicting evidence on the efficacy of different skin disinfectants for preventing surgical site infection (SSI). METHODS: We systematically searched PubMed, Web of Science, Cochrane Library, and Embase for RCTs published up to February 2025 comparing preoperative skin disinfection with povidone-iodine (PVI) versus chlorhexidine (CH). Primary outcomes were overall, superficial, deep, and organ/space SSI rates. Secondary outcomes included hospital stay, readmission, and reoperation. RESULTS: CH was superior to PVI in preventing overall SSI (26 studies, n = 29,356; RR: 0.89; 95% confidence interval [CI]: 0.80 to 0.99). The overall SSI incidence rate in the CH group was 7.1% (1,045/14,677), compared with 7.8% (1,152/14,679) in the PVI group, equating to an 11% reduction in relative risk and a 0.7% reduction in absolute risk. The number needed to treat to prevent one SSI was 143. CH demonstrated superiority over PVI in preventing superficial SSI (13 studies, n = 16,867; RR: 0.77; 95% CI: 0.64 to 0.92), but not for deep SSI (11 studies, n = 15,842; RR: 1.00; 95% CI: 0.77 to 1.29) or organ SSI (9 studies, n = 9,471; RR: 1.17; 95% CI: 0.89 to 1.53). No significant differences were found in hospital stay, readmission, or reoperation rates between the two groups. CONCLUSION: CH demonstrates statistical superiority over PVI in preventing overall and superficial SSI, though the absolute clinical benefit is modest. No significant differences were observed for deep or organ/space SSI, nor for secondary outcomes including hospital length of stay, readmission, or reoperation rates.

Humans

DNA damage produced by povidone-iodine in cultured human diploid cells.

Povidone-iodine is capable of selective altering the DNA of human diploid cells growing in culture. This finding extends to eukaryotic cells, the previously reported DNA-modifying activity of this agent for bacteria. In view of the known relationship between DNA-modifying activity and potential carcinogenicity, the results suggest that the potential hazards posed by the widespread use of this agent be evaluated.

Cells, Cultured

Absence of bacterial resistance to povidone iodine.

Povidone iodine is now being increasingly used in hospitals as an antiseptic. The possible habituation of bacteria to iodine was studied by serial passage of two strains of Pseudomonas aeruginosa, two strains of Escherichia coli, two strains of Klebsiella aerogenes, and one strain of Serratia marcescens in subinhibitory concentrations. After 20 passages, no significant change was observed in the minimal inhibitory concentration, minimal bactericidal concentration, and killing times between parent strains and 20th subcultures under standardized conditions.

Bacteria

Sterile preparation of the external auditory canal with povidone-iodine.

Sterile preparation of the external auditory canal is usually not undertaken, although the external auditory canal provides surgical access for several procedures involving the tympanic membrane, middle ear, and vesibule. This is due to the rarity of postoperative wound infections, as well as difficulty in sterilizing the external auditory canal. Four antiseptic solutions commonly used for operative preparation were tested to determine thrir potential for sterilizing the external auditory canal. Povidone-iodine solution was effective in sterilizing 90% of the external auditory canals of children and adults. This simple technique may find clinical use in surgical procedures involving the external auditory canal.

Acetone

Effect of povidone-iodine on Herpes genitalis.

Ten patients with vulvovaginal and cervical herpesvirus infections were treated with a regimen of external and intravaginal povidone-iodine preparations. In all but 1 case, the expected duration of symptoms and healing time were shortened. The response of cervical lesions was especially remarkable. The findings of this pilot study warrant further controlled clinical investigation.

Adult