Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017 Dec 19;12(12):e0189206.
doi: 10.1371/journal.pone.0189206. eCollection 2017.

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

Letícia Fernandes Barroso  1 , Sarah Pereira Cazella  1 , Antonio Brunno Nepomuceno  1 , Luiza Toscano  1 , Liliane Ângela de Souza Castilho  1 , Eloísa Marcela Rueda Furlan  1 , André Messias  1 , Ingrid U Scott  2   3 , Rodrigo Jorge  1
Affiliations
Randomized Controlled Trial

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

Letícia Fernandes Barroso et al. PLoS One. .

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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of the study.
T = time; PI = povidone-iodine 5%; SS = saline solution.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Speaker MG, Milch FA, Shah MK, Eisner W, Kreiswirth BN. Role of external bacterial flora in the pathogenesis of acute postoperative endophthalmitis. Ophthalmology. 1991;98: 639–49– discussion 650. - PubMed
    1. Bannerman TL, Rhoden DL, McAllister SK, Miller JM, Wilson LA. The source of coagulase-negative staphylococci in the Endophthalmitis Vitrectomy Study. A comparison of eyelid and intraocular isolates using pulsed-field gel electrophoresis. Arch Ophthalmol. 1997;115: 357–361. - PubMed
    1. Schwartz SG, Flynn HW. Update on the prevention and treatment of endophthalmitis. Expert Rev Ophthalmol. 2014;9: 425–430. doi: 10.1586/17469899.2014.951331 - DOI - PMC - PubMed
    1. Moss JM, Sanislo SR, Ta CN. A prospective randomized evaluation of topical gatifloxacin on conjunctival flora in patients undergoing intravitreal injections. Ophthalmology. Elsevier; 2009;116: 1498–1501. doi: 10.1016/j.ophtha.2009.02.024 - DOI - PubMed
    1. Ahmed Y, Scott IU, Pathengay A, Bawdekar A, Flynn HW. Povidone-iodine for endophthalmitis prophylaxis. Am J Ophthalmol. Elsevier; 2014;157: 503–504. doi: 10.1016/j.ajo.2013.12.001 - DOI - PubMed

Publication types

Substances