Antiseptics are considered beneficial for wound care as they help in promoting healing by preventing and treating infections. However, use of these agents is accompanied by several challenges like tolerability issues, inactivation by organic matter and emergence of antimicrobial resistance/cross-resistance. A significant link has been witnessed between the rising prevalence of antibiotic resistance and emergence of multidrug-resistant nosocomial infections, which appears to be a cause of concern. The researchers have reported that Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp (ESKAPE pathogens) are the leading pathogens implicated in the development of nosocomial infections worldwide, with many ESKAPE bacteria becoming multi-drug resistant.

It is believed that antiseptics may offer an alternative and viable option to effectively target these organisms. With regard to this, the investigators did a literature search on PubMed in January 2019, with a filter for the previous 5 years. Searches were based on the antimicrobial efficacy, antiseptic resistance, wound healing properties, and skin tolerability for the commonly used antiseptics, Povidone-Iodine (PVP-I), chlorhexidine gluconate (CHG), polyhexanide (PHMB), and octenidine (OCT). On comparing PVP-I with other agents, it was found that PVP-I exhibits a broader spectrum of antimicrobial action against Gram-negative bacteria, actinobacteria, bacterial spores, fungi and viruses, and a similar and broad spectrum of activity against Gram-positive bacteria. It was effective against all ESKAPE pathogens. In addition, it was highly effective at eradicating bacterial biofilms, which is an important consideration for wound care and infection control. Contrary to other antiseptics, no resistance or cross-resistance to PVP-I has been reported, despite a long history of extensive use. It has also been demonstrated that PVP-I has low allergenic potential, low cytotoxicity, remains effective in the presence of blood and can promote wound healing by increasing expression of transforming growth factor beta. On the basis of this data, it can be stated that PVP-I has great potential for managing antisepsis.

Source: International Journal of Antimicrobial Agents. 2020;56:106064.