Efficacy of topical povidone-iodine during the first week after ophthalmic surgery.
OBJECTIVE
In the first postoperative day, povidone-iodine ophthalmic solution prevents an increase in conjunctival bacterial colony-forming units and decreases the species compared with antibiotic. We sought to determine whether these beneficial effects of povidone-iodine could be sustained during the first postoperative week.


METHODS
In 42 eyes of 35 consecutive patients, one or two drops of either a broad-spectrum antibiotic (polymyxin B sulfate-neomycin sulfate-gramicidin) or povidone-iodine 1.25% to 2.5% were placed in the treated eye or eyes at the conclusion of surgery and three times daily during the first postoperative week. Bacterial cultures were taken from both eyes at the end of surgery before instillation of either of the eyedrops and again 1 week later. Twenty-eight untreated eyes served as a control group.


RESULTS
During the first postoperative week, the number of colony-forming units and species increased in both treatment groups. Relative to the control group, both medications effectively reduced the mean number of colony-forming units at 1 week (P < .02), but their effects on colony-forming units did not significantly differ from each other (80 +/- 290 for the povidone-iodine-treated eyes and 75 +/- 90 for the antibiotic-treated eyes). At 1 week, the species count increased 281% in the antibiotic group but only 106% in the povidone-iodine group. Compared to the control group, eyes that received povidone-iodine had a significantly lower species count (P = .0097).


CONCLUSIONS
Povidone-iodine ophthalmic solution is an alternative to postoperative topical antibiotics because of its effectiveness in controlling conjunctival bacterial colony-forming units and species, its relatively low cost, and its availability.
Isenberg
S J
SJ
Jules Stein Eye Institute, Department of Ophthalmology, UCLA School of Medicine 90095, USA. ISENBERG@UCLA.EDU
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D000287:Administration, Topical; D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D001419:Bacteria / Q000302:isolation & purification; D015169:Colony Count, Microbial / Q000379:methods; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000494:pharmacology; D005123:Eye / Q000382:microbiology*; D005128:Eye Diseases / Q000601:surgery; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000517:prevention & control*; D006801:Humans; D009883:Ophthalmic Solutions; D011184:Postoperative Period; D011206:Povidone-Iodine / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D009883:Ophthalmic Solutions; D011206:Povidone-Iodine