Journal Updates

COVID-19. How safe is PVP-I?

Add to my interests Add the following topics to my interests. Pneumonia, Health Diversity

PVP-I is well-tolerated when compared with other gargled antiseptic agents commonly used. Clinical trials have shown that nasal inhalation and gargling with PVP-I can reduce the incidence of nosocomial pneumonia by reducing pharyngeal bacterial colonisation.

Two studies assessing the effect of prolonged use of PVP-I mouthwash reported that it did not affect thyroid function either when used four times daily (2 weeks) or when used once daily (6 months).

The renal iodine clearance rate is not impacted by the iodine intake. The World Health Organization recommends daily allowance of 0.15 mg iodine for an adult. PVVP-I contains an equivalent of 11 mg/mL of iodine.

There are certain cases of significant iodine toxicity with topical PVP-I use. Instances when iodine toxicity have been reported included are prolonged sinus irrigations and prolonged wound application for 3 to 5 weeks, both using a 10% solution of PVP-I.

In a study, it was concluded that, “in COVID-19, it is not known yet whether the salivary glands are directly infected or what contribution to the salivary virus load is made by plasma passing into the oral cavity via crevicular fluid. Hence, in deciding the dosing regimen for patients and healthcare workers we balance the risk of iodine toxicity versus the protective effect of PVP-I.”

The safety profile of PVP-I has been well-established. Incidents of allergy have been rarely reported with PVP-I, and in clinical trial only 2 out of 500 patients showed positive contact sensitivity to PVP-I.

Resource:

Kirk-Bayley J, Challacombe S, Sunkaraneni S, Combes J. The use of povidone iodine nasal spray and mouthwash during the current COVID 19 pandemic may protect healthcare workers and reduce cross infection. SSRN. 2020. Available at SSRN: https://ssrn.com/abstract=3563092 or http://dx.doi.org/10.2139/ssrn.3563092 Shiraishi T, Nakagawa Y. Evaluation of the bactericidal activity of povidone-iodine and commercially available gargle preparations. Dermatology (Basel, Switzerland) 2002; 204 Suppl: 37–41 Ferguson MM, Geddes DA, Wray D. The effect of a povidone-iodine mouthwash upon thyroid function and plaque accumulation. British Dental Journal 1978. DOI:10.1038/sj.bdj.4804017. Ader AW, Paul TL, Reinhardt W, et al. Effect of mouth rinsing with two polyvinylpyrrolidone-iodine mixtures on iodine absorption and thyroid function. Journal of Clinical Endocrinology and Metabolism 1988. DOI:10.1210/jcem-66-3-632. Verger P, Aurengo A, Geoffroy B, le Guen B. Iodine kinetics and effectiveness of stable iodine prophylaxis after intake of radioactive iodine: a review. Thyroid: official journal of the American Thyroid Association 2001; 11: 353–60. Lachapelle JM. Allergic contact dermatitis from povidone-iodine: A re-evaluation study. Contact Dermatitis 2005. DOI:10.1111/j.0105-1873.2005.00479.x. Ramaswamykanive H, Nanavati Z, Mackie J, Linderman R, Lavee O. Cardiovascular collapse following povidone-iodine wash. Anaesthesia and Intensive Care. 2011. DOI:10.1177/0310057x1103900121. dela Cruz F, Brown DH, Leikin JB, Franklin C, Hryhorczuk DO. Iodine absorption after topical administration. Western Journal of Medicine 1987.