Antibiotic resistance is a major public health problem globally and is spreading continually. Several antibiotic resistant strains have emerged in hospital settings, notably the vancomycin-resistant enterococci (VRE). Enterococci faecium, the microorganism responsible for various nosocomial infections, has shown limited resistance to alcohol-based sanitizers. Multipronged infection prevention practices are now gaining acceptance.

Povidone iodine (PVP-I) is a widely available and commonly used antiseptic in diverse clinical settings. It has potent antibacterial, antiviral and antifungal properties. PVP-I has also shown activity against fungi and spores. This broader spectrum of antimicrobial action, compared to other available antiseptics, is attributed to multimodal action. The other advantages of PVP-I are a lack of reported resistance or cross-resistance, in contrast to other antiseptics, and an excellent safety profile. The World Health Organization (WHO) has included PVP-I in its List of Essential Medicines. PVP-I has shown strong virucidal activity against hepatitis A virus and respiratory viruses such as influenza, Middle-East Respiratory Syndrome (MERS) and Sudden Acute Respiratory Syndrome (SARS) coronaviruses. PVP-I is used extensively in surgical settings preoperatively for surgical site preparation. Preoperative skin antisepsis reduces the risk of skin flora being introduced in the body during the surgery. Hand washing with PVP-I-based antiseptics has been shown to effectively decontaminate the skin. Similarly, studies have shown PVP-I mouthwashes and gargles to significantly reduce viral load in the oral cavity and the oropharynx. The rising prevalence of antibiotic resistance has focused attention on the use of antiseptics, in reducing infections in hospital settings. PVP-I is a time tested antiseptic; the broad spectrum of action, wide availability and accessibility, lack of reported resistance and excellent safety and tolerability profile make PVP-I an “affordable, potent, and widely available antiseptic option”.

Eggers M. Infect Dis Ther. 2019 Dec;8(4):581-593.