Efficacy of Intraoperative Antiseptic Techniques in the Prevention of Periprosthetic Joint Infection: Superiority of Betadine

Cichos, Kyle H.; Andrews, Rachel M.; Wolschendorf, Frank; Narmore, Whitney; Mabry, Scott E.; Ghanem, Elie

doi:10.1016/j.arth.2019.02.002

Cited by 33 publications

(26 citation statements)

References 26 publications

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“…In vitro studies have confirmed the bactericidal activity of PVP-I 10% solution against clinical isolates of MSSA and MRSA using both suspension tests ( 28 , 37 , 39 , 42 – 45 ) and surface test methods ( 46 ). In these studies, the action of PVP-I against MSSA and MRSA was rapid, with bactericidal activity typically observed within 15 to 60 s ( 39 , 43 , 45 ).…”

Section: Povidone Iodinementioning

confidence: 85%

“…PVP-I has several properties which make it an attractive option for S. aureus decolonization, including strong antistaphylococcal activity in in vitro and ex vivo models, and uniform activity against S. aureus regardless of the presence of antibiotic or antiseptic resistance ( 28 , 39 , 40 , 42 – 44 , 46 ). Of note, a lack of acquired bacterial resistance or cross-resistance to antibiotics or other antiseptics has been observed with PVP-I use ( 20 , 23 , 28 , 37 , 55 – 58 ).…”

Section: State Of the Art And Perspectivesmentioning

confidence: 99%

“…Furthermore, clinical trial data suggest that intranasal PVP-I demonstrates favorable efficacy in the preoperative decolonization of MRSA and prevention of SSI, compared with chlorhexidine and mupirocin ( 22 , 71 , 74 ). Table 3 summarizes the properties of PVP-I, chlorhexidine, and mupirocin ( 22 , 23 , 28 , 37 , 39 , 40 , 42 – 47 , 57 , 58 , 71 , 72 , 81 – 101 ).…”

Section: State Of the Art And Perspectivesmentioning

confidence: 99%

“…In these studies, the action of PVP-I against MSSA and MRSA was rapid, with bactericidal activity typically observed within 15 to 60 s (39,43,45). Comparative in vitro studies have generally showed that, irrespective of exposure time or dilution, 10% PVP-I was more active than chlorhexidine against MRSA and was bactericidal against chlorhexidine-resistant strains (28,39,42,44,46). Furthermore, two in vitro studies also showed that 5% PVP-I cream had bactericidal activity against MSSA, MRSA, and mupirocin-resistant strains of MRSA (40,43).…”

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confidence: 99%

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Povidone Iodine: Properties, Mechanisms of Action, and Role in Infection Control and Staphylococcus aureus Decolonization

Lepelletier¹,

Maillard

Pozzetto

et al. 2020

Antimicrob Agents Chemother

123

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Nasal decolonization is an integral part of the strategies used to control and prevent the spread of methicillin-resistant Staphylococcus aureus (MRSA) infections. The two most commonly used agents for decolonization are intranasal mupirocin 2% ointment and chlorhexidine wash but the increasing emergence of resistance and treatment failure has underscored the need for alternative therapies. This article discusses povidone iodine (PVP-I) as an alternative decolonization agent and is based on literature reviewed during an Expert's workshop on resistance and MRSA decolonization. When compared to chlorhexidine and mupirocin, respectively, PVP-I 10% and 7.5% solution had rapid and superior bactericidal activity against MRSA in in vitro and ex vivo studies. Notably, PVP-I 10% and 5% solutions were also active against both chlorhexidine-resistant and mupirocin-resistant strains, respectively. Unlike chlorhexidine and mupirocin, available reports have not observed a link between PVP-I and the induction of bacterial resistance or cross-resistance to antiseptics and antibiotics. These pre-clinical findings also translate into clinical decolonization, where intranasal PVP-I significantly improved the efficacy of chlorhexidine wash and was as effective as mupirocin in reducing surgical site infection (SSI) in orthopedic surgery. Overall, these qualities of PVP-I make it a useful alternative decolonizing agent for the prevention of S. aureus infections, but additional experimental and clinical data are required to further evaluate the use of PVP-I in this setting.

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Section: Povidone Iodinementioning

confidence: 85%

Section: State Of the Art And Perspectivesmentioning

confidence: 99%

Section: State Of the Art And Perspectivesmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Povidone Iodine: Properties, Mechanisms of Action, and Role in Infection Control and Staphylococcus aureus Decolonization

Lepelletier¹,

Maillard

Pozzetto

et al. 2020

Antimicrob Agents Chemother

123

View full text Add to dashboard Cite

show abstract

“…In antimicrobial testing, povidone-iodine has been shown to kill methicillin-resistant Staphylococcus aureus and other antibiotic-resistant strains within 20-30 seconds of exposure [13], [15]. Cichos et al [16] also highlighted the in vitro polymicrobial efficacy of povidone-iodine against Staphylococcus epidermidis , Haemophilus influenzae , Pseudomonas aeruginosa , Burkholderia cepacia , and Escherichia coli .…”

Section: Discussionmentioning

confidence: 99%

Intraoperative povidone-iodine irrigation for infection prevention

Goswami

Austin

2019

Arthroplasty Today

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Although prevention of infection following arthroplasty requires a multifaceted approach, the use of intraoperative irrigation is an important component of any protocol. Recent clinical practice guidelines from the Centers for Disease Control, World Health Organization, and International Consensus Meeting on Musculoskeletal Infection advocate the use of a dilute povidone-iodine solution prior to wound closure. Our experience suggests that this practice is safe, inexpensive, and easily implemented. The present article describes our institutional irrigation protocol and reviews the current literature regarding povidone-iodine solutions.

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Comparative Genomic Analysis of Bacterial Data in BV-BRC: An Example Exploring Antimicrobial Resistance

Wattam,

Bowers,

Brettin

et al. 2024

Methods in Molecular Biology

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Efficacy of Intraoperative Antiseptic Techniques in the Prevention of Periprosthetic Joint Infection: Superiority of Betadine

Cited by 33 publications

References 26 publications

Povidone Iodine: Properties, Mechanisms of Action, and Role in Infection Control and Staphylococcus aureus Decolonization

Povidone Iodine: Properties, Mechanisms of Action, and Role in Infection Control and Staphylococcus aureus Decolonization

Intraoperative povidone-iodine irrigation for infection prevention

Comparative Genomic Analysis of Bacterial Data in BV-BRC: An Example Exploring Antimicrobial Resistance

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