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Using antiseptics in wound care can promote healing by preventing and treating infection. However, using antiseptics can present many challenges, including issues with tolerability, inactivation by organic matter and the emergence of antimicrobial resistance/cross-resistance.
A new study published in the International Journal of Antimicrobial Agents aimed to discussed the key challenges in antisepsis, focusing on povidone-iodine (PVP-I) antiseptic.
This review of literature conducted searches in PubMed, in January 2019, with a filter for the previous 5 years – based on the antimicrobial efficacy, antiseptic resistance, wound healing properties, and skin tolerability for the commonly used antiseptics PVP-I, chlorhexidine gluconate (CHG), polyhexanide (PHMB), and octenidine (OCT).
It was found that when compared with CHG, PHMB and OCT, PVP-I had a broader spectrum of antimicrobial activity against Gram-negative bacteria, actinobacteria, bacterial spores, fungi and viruses, and a similar and broad spectrum of activity against Gram-positive bacteria. PVP-I was also highly effective at eradicating bacterial biofilms, which is a vitally important consideration for wound care and infection control. In addition, despite a long history of extensive use, no resistance or cross-resistance to PVP-I has been recorded, unlike for other antiseptics. Furthermore, PVP-I was found to have low allergenic properties, low cytotoxicity and can promote wound healing through increased expression of transforming growth factor beta.
It was therefore concluded that with increased understanding of the importance of tackling antimicrobial resistance and bacterial biofilms in acute and chronic wound care, alongside improved understanding of the challenges of antiseptic use, PVP-I remains a promising agent for the management of antisepsis.
Source: International Journal of Antimicrobial Agents. 2020 Sep;56(3):106064. doi:10.1016/j.ijantimicag.2020.106064.