Topical Povidone-Iodine as an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis

Mullings, Warren; Panchmatia, Rikesh; Samoy, Katrien; Habib, Al‐Rahim; Thamboo, Andrew; Al-Salman, Rami; Javer, Amin R.

doi:10.5152/ejra.2019.166

Cited by 12 publications

(11 citation statements)

References 21 publications

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“…19 Repeated use of dilute 0.08% PVP-I every other day in patients with chronic rhinosinusitis for up to 7 weeks did not result in any adverse effects on mucociliary clearance or olfaction. 20,21 When administered intranasally in humans, there is an effective dilution of the applied formulation as it is immediately combined with the existing nasal secretions. 22 In addition to the 95% aqueous component of the nasal secretions, intranasally applied PVP-I also encounters mucin products released from goblet cells and submucosal glands including glycoproteins, proteoglycans, and lipids.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2

Frank

Brown

Capriotti³

et al. 2020

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Research is needed to demonstrate the efficacy of nasal povidone-iodine (PVP-I) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVE To evaluate the in vitro efficacy of PVP-I nasal antiseptic for the inactivation of SARS-CoV-2 at clinically significant contact times of 15 and 30 seconds. INTERVENTIONS The SARS-CoV-2, USA-WA1/2020 strain, virus stock was tested against nasal antiseptic solutions consisting of aqueous PVP-I as the sole active ingredient. Povidone-iodine was tested at diluted concentrations of 0.5%, 1.25%, and 2.5% and compared with controls. The test solutions and virus were incubated at mean (SD) room temperature of 22 (2)°C for time periods of 15 and 30 seconds. DESIGN AND SETTING This controlled in vitro laboratory research study used 3 different concentrations of study solution and ethanol, 70%, as a positive control on test media infected with SARS-CoV-2. Test media without virus were added to 2 tubes of the compounds to serve as toxicity and neutralization controls. Ethanol, 70%, was tested in parallel as a positive control and water only as a negative control. MAIN OUTCOMES AND MEASURES The primary study outcome measurement was the log reduction value after 15 seconds and 30 seconds of given treatment. Surviving virus from each sample was quantified by standard end point dilution assay, and the log reduction value of each compound was compared with the negative (water) control. RESULTS Povidone-iodine nasal antiseptics at concentrations (0.5%, 1.25%, and 2.5%) completely inactivated SARS-CoV-2 within 15 seconds of contact as measured by log reduction value of greater than 3 log 10 of the 50% cell culture infectious dose of the virus. The ethanol, 70%, positive control did not completely inactivate SARS-CoV-2 after 15 seconds of contact. The nasal antiseptics tested performed better than the standard positive control routinely used for in vitro assessment of anti-SARS-CoV-2 agents at a contact time of 15 seconds. No cytotoxic effects on cells were observed after contact with each of the nasal antiseptics tested. CONCLUSIONS AND RELEVANCE Povidone-iodine nasal antiseptic solutions at concentrations as low as 0.5% rapidly inactivate SARS-CoV-2 at contact times as short as 15 seconds. Intranasal use of PVP-I has demonstrated safety at concentrations of 1.25% and below and may play an adjunctive role in mitigating viral transmission beyond personal protective equipment.

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Section: Discussionmentioning

confidence: 99%

In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2

Frank

Brown

Capriotti³

et al. 2020

JAMA Otolaryngol Head Neck Surg

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“…Repeated administration of PVP-I to the sinonasal mucosa has been described as a safe and effective treatment for chronic sinus disease. This application did not cause any significant effect on mucociliary clearance or olfaction [ 17 , 18 ]. According to these studies, PVP-I did not cause pathological effects on paracellular permeability or cilia beat frequency at concentration of 1.25% [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Tolerability and usability of 0.5% PVP-I gargles and nasal drops in 6692 patients: Observational study

Khan¹,

Parab²

2021

American Journal of Otolaryngology

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“…The intranasal topical application of 0.08% solution of iodine for the treatment of recalcitrant chronic rhinosinusitis has been described by the St. Paul's Sinus Centre team in Vancouver [17,18]. This application did not cause any significant effect on thyroid function, mucociliary clearance or olfaction.…”

Section: Discussionmentioning

confidence: 99%

Repurposing 0.5% povidone iodine solution in otorhinolaryngology practice in Covid 19 pandemic

Khan¹,

Parab²,

Paranjape³

2020

American Journal of Otolaryngology

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SARS CoV 2 is very much homologous in structure to SARS CoV. Review of literature suggests the in-vitro virucidal action of povidone iodine in SARS CoV and MERS. The oropharynx and nasopharynx are target sites of SARS CoV 2. A significant proportion of COVID 19 sufferers are asymptomatic, but shedding these viral particles, PVP-I has been shown to be a safe therapy when used as a mouthwash or taken nasally or used during ophthalmic surgeries. Aims:1. To propose the use of 0.5% Povidone iodine gargles and nasal drops as prerequisite for office based nose and throat examination and procedures during COVID 19 pandemic. 2. To assess tolerability of 0.5% PVP-I in patients and in healthcare workers. Materials and methods: 0.5% PVP-I solution is prepared from commercially available 10% PVP-I solution.Patients were instructed to put 0.5% PVP-I drops in nose and rinse mouth with gargle prior examinations for 30 s. For endoscopic procedure (nasal and throat) nasal douching and gargling to be started one day prior. Douching and rinsing to be repeated just before procedures. Nasal packing with 0.5% PVP-I along with 4% xylocaine/adrenaline solution, tolerability and any allergic reaction noted. Results: The patient and health care workers tolerated the 0.5%. No allergy was noted. Conclusion:We propose the use of 0.5% PVP-I in healthcare workers and their patients to minimise the risk of spread of the disease in addition to the recommended PPE.

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Topical Povidone-Iodine as an Adjunctive Treatment for Recalcitrant Chronic Rhinosinusitis

Cited by 12 publications

References 21 publications

In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2

In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2

Tolerability and usability of 0.5% PVP-I gargles and nasal drops in 6692 patients: Observational study

Repurposing 0.5% povidone iodine solution in otorhinolaryngology practice in Covid 19 pandemic

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