Comparative efficacy of two different topical povidone-iodine 5% regimens in reducing conjunctival bacterial flora: A randomized parallel double-masked clinical trial

Author(s)

Barroso, Leticia Fernandes ^[1] ; Cazella, Sarah Pereira ^[1] ; Nepomuceno, Antonio Brunno ^[1] ; Toscano, Luiza ^[1] ; de Souza Castilho, Liliane Angela ^[1] ; Rueda Furlan, Eloisa Marcela ^[1] ; Messias, Andre ^[1] ; Scott, Ingrid U. ^{[2, 3]} ; Jorge, Rodrigo ^[1]

Affiliation

^[1] Univ Sao Paulo, Dept Ophthalmol Otorhinolaryngol & Head & Neck Su, Sch Med Ribeirao Preto, Ribeirao Preto, SP - Brazil

^[2] Penn State Coll Med, Dept Ophthalmol, Hershey, PA - USA

^[3] Penn State Coll Med, Dept Publ Hlth Sci, Hershey, PA - USA

• Document type: Journal article
• Source: PLoS One; v. 12, n. 12 DEC 19 2017.
• Web of Science Citations: 2

Abstract

Introduction The increasing prevalence of multi-resistant bacteria is a major public health concern. Infections acquired during ophthalmic surgery are devastating. The purpose of the current study is to compare the proportion of eyes with negative bacterial cultures on all tested media after 1 versus 3 sequential drops of povidone-iodine (PI) 5% into the inferior conjunctival fornix. Methods Patients were randomly assigned to receive 1 (PI group) drop (at time 28 minutes) or 3 (PI plus group) sequential drops (at time 0, 20 minutes and 28 minutes) of PI 5% into the inferior conjunctival sac of one randomly selected eye. A swab culture was obtained from the inferior conjunctival fornix 5 minutes before and 30 minutes after time 0. Central corneal thickness (CCT) was measured shortly before time 0 and shortly after time 30. Conjunctival swabs were incubated aerobically in enriched Thioglycolate liquid medium (meat broth) and in three solid culture media (chocolate agar, trypticase soy agar with 5% sheep blood, and Sabouraud agar). Results There was no significant difference in the proportion of negative cultures after intervention between groups (p = 0.1638). Also in the PI group (n = 59), the proportion of eyes with negative cultures after PI (79.7%) did not differ significantly from baseline (76.3%; p = 0.7539). However in the PI plus group (n = 61), the proportion of eyes with all negative cultures after PI (85.3%) was significantly higher than before PI (70.5%) (p = 0.0177). There was no significant difference in mean CCT before and after the intervention in both groups. Conclusion Instillation of 3 sequential drops of PI was associated with a significant increase in the proportion of eyes with all negative cultures, while instillation of a single drop of PI was not associated with a significant increase in the proportion of negative cultures. Further study is warranted to determine whether the difference between the PI administration regimens is also associated with differences in the rates of postoperative ocular infections. (AU)

• FAPESP's process: 10/17350-6 - Comparative efficacy of two different regimens of povidone-iodine 5% eye drops instillation in reducing conjunctival bacterial flora
• Grantee: Rodrigo Jorge
• Support Opportunities: Regular Research Grants
• FAPESP's process: 13/03443-0 - Comparative efficacy of two different regimens of povidone-iodine 5% eye drops instillation in reducing conjunctival bacterial flora
• Grantee: Letícia Fernandes Barroso
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)