The Experts below are selected from a list of 15825 Experts worldwide ranked by ideXlab platform
Sherwin J. Isenberg - One of the best experts on this subject based on the ideXlab platform.
-
prospective randomized clinical trial of Povidone iodine 1 25 solution versus topical antibiotics for treatment of bacterial keratitis
American Journal of Ophthalmology, 2017Co-Authors: Sherwin J. Isenberg, Mario Valenton, Savitri Sharma, Prashant Garg, Philip A Thomas, Pragya Parmar, Jayaraman Kaliamurthy, Johann M Reyes, Peter D ChristensonAbstract:Purpose To compare Povidone-iodine 1.25% ophthalmic solution with topical antibiotics for treatment of bacterial keratitis in areas of the world where use of effective topical antibiotics may not be an option. Study Design Randomized, controlled, investigator-masked clinical trial. Methods We randomized 172 individuals with bacterial keratitis to topical treatment with Povidone-iodine or antibiotics (neomycin–polymyxin B–gramicidin in the Philippines; ciprofloxacin 0.3% in India). Using survival analysis, we compared intervals from start of treatment to "presumed cure" (primary outcome measure, defined as a closed epithelial defect without associated inflammatory signs) and to "recovering" (residual epithelial defect 2 with only minimal inflammation). Results Median interval to presumed cure in the Philippines was 7 days for Povidone-iodine and 7 days for neomycin–polymyxin B–gramicidin (95% confidence interval [CI] for difference in median interval, −9.5 to 0.7 days) and in India was 12 days for Povidone-iodine and 17 days for ciprofloxacin (95% CI, −35.2 to 3.2 days). Hazard ratio (HR) for presumed cure among those treated with Povidone-iodine (vs antibiotics) was 1.46 in the Philippines (95% CI, 0.90–2.36; P = .13) and 1.70 in India (95% CI, 0.73–3.94; P = .22). Comparisons of intervals to recovering and HR for recovering also revealed no significant differences between treatment groups in either country. Conclusions There is no significant difference between the effect of topical Povidone-iodine 1.25% and topical antibiotics commonly available in the developing world for treatment of bacterial keratitis. Povidone-iodine 1.25%, which is widely available and inexpensive, can be considered for treatment of bacterial keratitis when antibiotic treatment is not practical.
-
The effect of Povidone-iodine solution applied at the conclusion of ophthalmic surgery
American Journal of Ophthalmology, 1995Co-Authors: Leonard Apt, Robert Yoshimori, Sherwin J. Isenberg, Alvin Chang, Geoffrey C. Lam, Brian S Boxer Wachler, Doron NeumannAbstract:Purpose Povidone-iodine 5% solution decreases the incidence of postoperative endophthalmitis when used on the eye for preoperative preparation. We sought to determine whether it also minimized conjunctival bacterial flora immediately after surgery by preventing bacteria present on the surface of the eye from entering surgical wounds. Methods In 42 eyes of 40 patients, at the conclusion of surgery, on an alternating basis, each patient received either a drop of a broad-spectrum antibiotic solution (polymyxin B sulfate-neomycin sulfate-gramicidin) or a 5% Povidone-iodine solution in the operated-on eye. Bacterial cultures were taken before and after surgery and 24 hours later. The 38 unoperated-on eyes in the unilateral cases served as control eyes. Results Relative to the control group, Povidone-iodine was effective in preventing an increase in the number of colony-forming units (P = .035), while the antibiotic was not. At 24 hours after surgery, the species count was lower in the eyes receiving Povidone-iodine than in the antibiotic-treated eyes (P = .034) and was increased in the antibiotic group since the completion of surgery (P = .013), but was lower in the Povidone-iodine and antibiotic groups than in the control eyes for both groups (P Conclusions Povidone-iodine 5% solution applied to the eye at the conclusion of surgery was more effective at minimizing the number of colony-forming units and species for the first postoperative day than was a broad-spectrum antibiotic. While not true for the antibiotic, the antimicrobial effect of Povidone-iodine lasted for at least 24 hours after the completion of surgery.
Cristina Sampaio - One of the best experts on this subject based on the ideXlab platform.
-
skin antiseptics in venous puncture site disinfection for prevention of blood culture contamination systematic review with meta analysis
Journal of Hospital Infection, 2011Co-Authors: Daniel Caldeira, Claudio David, Cristina SampaioAbstract:Summary Blood cultures drawn by venous puncture are common clinical procedures for the detection of bacteraemia. Blood culture contamination (BCC) can lead to clinical misinterpretation and unnecessary expenses. We aimed to systematically review randomised controlled trials (RCTs) with skin antiseptics for prevention of contamination in venous-puncture drawn blood cultures. We conducted database search using CENTRAL ( Cochrane Library issue April 2010), MEDLINE, EMBASE and mRCT, in June 2010. All RCTs testing skin antiseptics in venous-puncture drawn blood cultures were retrieved. Relative risk (RR) of the BCC outcome was analysed by random effects method using confidence interval (CI) of 95%. Studies were assessed by one review author and checked by another. Six studies were identified. Single-trial comparisons showed that alcoholic iodine tincture was better than non-alcoholic Povidone-iodine, and isopropyl/acetone/Povidone-iodine showed superiority against isopropyl/Povidone-iodine. Meta-analysis demonstrated that alcoholic chlorhexidine was better than non-alcoholic Povidone-iodine (RR: 0.33; 95% CI: 0.24–0.46) in 4757 blood cultures from two trials. Alcoholic solutions were better than non-alcoholic products (0.53; 0.31–0.90) in 21 300 blood cultures from four studies. Two trials with 13 418 blood cultures showed that iodine tincture was not superior to Povidone-iodine in BCC prevention (0.79; 0.54–1.18). Alcoholic iodine was not different from non-alcoholic iodine (0.79; 0.53–1.17). Comparison of chlorhexidine vs iodine compounds was not conclusive. Alcohol alone was not inferior to iodinated products for prevention of contamination in venous-puncture drawn blood cultures. The association of alcohol and Povidone-iodine did not seem to be useful. Alcoholic chlorhexidine solutions reduced blood culture false positives compared with aqueous Povidone-iodine.
Olivier Mimoz - One of the best experts on this subject based on the ideXlab platform.
-
Effect of oropharyngeal Povidone-iodine preventive oral care on ventilator-associated pneumonia in severely brain-injured or cerebral hemorrhage patients: a multicenter, randomized controlled trial.
Critical Care Medicine, 2014Co-Authors: Philippe Seguin, Olivier Mimoz, Bruno Laviolle, Claire Dahyot-fizelier, Romain Dumont, Benoit Veber, Soizic Gergaud, Karim Asehnoune, Pierre-yves Donnio, Eric BellissantAbstract:OBJECTIVE: To evaluate the efficacy and safety of oral care with Povidone-iodine on the occurrence of ventilator-associated pneumonia in a high-risk population. DESIGN: A multicenter, placebo-controlled, randomized, double-blind, two-parallel-group trial performed between May 2008 and May 2011. SETTING: Six ICUs in France. PATIENTS: One hundred seventy-nine severely brain-injured patients (Glasgow Coma Scale ≤ 8) or cerebral hemorrhage expected to be mechanically ventilated for more than 24 hours. INTERVENTIONS: Participants were randomly assigned to receive oropharyngeal care with Povidone-iodine (n = 91) or placebo (n = 88) six times daily until mechanical ventilation withdrawal. MEASUREMENTS AND MAIN RESULTS: Primary endpoint was the rate of ventilator-associated pneumonia. Secondary endpoint included the rates of ventilator-associated tracheobronchitis and acute respiratory distress syndrome and patient's outcome. The number of patients evaluable for the primary endpoint (preplanned modified intention-to-treat population) was 150 (78 in the Povidone-iodine group, 72 in the placebo group). Ventilator-associated pneumonia occurred in 24 patients (31%) in the Povidone-iodine group and 20 (28%) in the placebo group (relative risk, 1.11 [95% CI, 0.67-1.82]; p = 0.69). There was no significant difference between the two groups for ventilator-associated tracheobronchitis: eight patients (10%) in the Povidone-iodine group and five patients (7%) in the placebo group (relative risk, 1.48 [95% CI, 0.51-4.31]; p = 0.47). Acute respiratory distress syndrome occurred in five patients in the Povidone-iodine group but not in the placebo group (p = 0.06). There was no difference between groups for ICU and hospital lengths of stay, as well as ICU and 90-day mortality. CONCLUSIONS: There is no evidence to recommend oral care with Povidone-iodine to prevent ventilator-associated pneumonia in high-risk patients. Furthermore, this strategy seems to increase the rate of acute respiratory distress syndrome.
-
chlorhexidine compared with Povidone iodine as skin preparation before blood culture a randomized controlled trial
Annals of Internal Medicine, 1999Co-Authors: Olivier Mimoz, Amal Karim, Alain Mercat, Marie Cosseron, Bruno Falissard, Fabrice Parker, C Richard, K Samii, Patrice NordmannAbstract:BACKGROUND: Chlorhexidine is better than Povidone-iodine for care of catheter sites, but it is not known whether chlorhexidine is superior in reducing blood culture contamination. OBJECTIVE: To determine whether alcoholic chlorhexidine is a more effective skin antiseptic for collection of blood cultures than aqueous Povidone-iodine. DESIGN: Randomized, controlled trial. SETTING: Three adult intensive care units in a French university hospital. PATIENTS: 403 adults who had at least one blood culture drawn through a peripheral vein. INTERVENTIONS: Patients were randomly assigned to receive skin preparation with an aqueous solution of 10% Povidone-iodine or an alcoholic solution of 0.5% chlorhexidine before phlebotomy. MEASUREMENTS: Contamination rates of blood cultures. RESULTS: Of 2041 blood cultures collected in 403 patients, 124 yielded pathogens. Chlorhexidine reduced the incidence of blood culture contamination more than Povidone-iodine (14 of 1019 cultures [1.4%] compared with 34 of 1022 cultures [3.3%]; odds ratio, 0.40 [95% CI, 0.21 to 0.75]; P = 0.004). CONCLUSION: Skin preparation with alcoholic chlorhexidine is more efficacious than skin preparation with aqueous Povidone-iodine in reducing contamination of blood cultures.
Fu Ce-shu - One of the best experts on this subject based on the ideXlab platform.
-
Preparation and stability of Povidone iodine solution
Journal of Hainan Medical University, 2010Co-Authors: Fu Ce-shuAbstract:Objective:To establish a method for Povidone iodine solution preparation.Methods:Stability improvement of Povidone iodine solution was achieved by adding buffer solution to adjust pH and stabilizing agents.Results:Povidone iodine solution was stable when pH should was 5.0～6.0;Potassium iodate could improve the stability of the Povidone iodine solution.Conclusion:The above mentioned method is a simple way for industrial production of Povidone iodine solution.
Patrice Nordmann - One of the best experts on this subject based on the ideXlab platform.
-
chlorhexidine compared with Povidone iodine as skin preparation before blood culture a randomized controlled trial
Annals of Internal Medicine, 1999Co-Authors: Olivier Mimoz, Amal Karim, Alain Mercat, Marie Cosseron, Bruno Falissard, Fabrice Parker, C Richard, K Samii, Patrice NordmannAbstract:BACKGROUND: Chlorhexidine is better than Povidone-iodine for care of catheter sites, but it is not known whether chlorhexidine is superior in reducing blood culture contamination. OBJECTIVE: To determine whether alcoholic chlorhexidine is a more effective skin antiseptic for collection of blood cultures than aqueous Povidone-iodine. DESIGN: Randomized, controlled trial. SETTING: Three adult intensive care units in a French university hospital. PATIENTS: 403 adults who had at least one blood culture drawn through a peripheral vein. INTERVENTIONS: Patients were randomly assigned to receive skin preparation with an aqueous solution of 10% Povidone-iodine or an alcoholic solution of 0.5% chlorhexidine before phlebotomy. MEASUREMENTS: Contamination rates of blood cultures. RESULTS: Of 2041 blood cultures collected in 403 patients, 124 yielded pathogens. Chlorhexidine reduced the incidence of blood culture contamination more than Povidone-iodine (14 of 1019 cultures [1.4%] compared with 34 of 1022 cultures [3.3%]; odds ratio, 0.40 [95% CI, 0.21 to 0.75]; P = 0.004). CONCLUSION: Skin preparation with alcoholic chlorhexidine is more efficacious than skin preparation with aqueous Povidone-iodine in reducing contamination of blood cultures.
