Antiseptics in the era of bacterial resistance: a focus on povidone iodine

Abstract

Antiseptics have broader spectrums of antimicrobial activity than antibiotics and a much lower risk of bacterial resistance selection. Antiseptics are therefore appropriate alternatives to antibiotics for the management of localized superficial skin infections. Povidone iodine has the broadest spectrum of antimicrobial activity of the available antiseptics, and has a rapid and persistent microbicidal effect. It is active against Gram-positive and -negative bacteria, bacterial spores, fungi, protozoa and several viruses, including H1N1 influenza virus (swine flu). It also has good skin tolerance, and is only a weak allergen: it is rarely associated with immediate allergic reactions, which are more prevalent with chlorhexidine. It has also been shown to promote wound healing. Although additional data are needed from well-designed clinical trials, povidone iodine 10% can be considered as a first-choice antiseptic for the prevention and treatment of superficial skin infections.