Impact of Povidone-iodine Versus Chlorhexidine for Periurethral Cleaning Before Catheterization on Pyuria and Bacteriuria Among Emergency Department Patients

Background: We aimed to determine the effect of periurethral cleaning before catheterization using chlorhexidine and povidone-iodine on bacteriuria and pyuria. Methods: This study was a single-blind clinical trial on a sample selected by convenience sampling. Demographic and clinical questionnaires were completed, and patients were randomly divided into two groups) 36 patients each of povidone-iodine and chlorhexidine using Minimization Software based on confounding variables including age, consciousness level, triage level, nutritional status, and underlying disease. The periurethral areas were cleaned with the given antiseptics and catheterized using standard and sterile procedures. Then, specimens were taken for urinalysis and urine culture immediately, 72 hours, and five days after catheterization. Then, bacteriuria rate, pyuria rate, and the number of microorganisms were determined through examinations. Data analysis was conducted using SPSS version 19. Results: There was no statistically significant difference in the bacteriuria rate between the two groups immediately (P = 0.76), 72 hours (P = 0.22), and five days (P = 0.50) after catheterization. The positive pyuria rate was not significantly different between the two groups immediately after catheterization. However, it was significantly higher in the povidone-iodine group 72 hours (P = 0.03) and five days (P = 0.004) after catheterization. The Mann-Whitney test compared the mean number of microorganisms between the two groups at different times. This test showed no significant difference in the number of microorganisms immediately (P = 0.93), 72 hours (P = 0.43), and five days (P = 0.61) after catheterization. Conclusions: Due to the lower side effects of chlorhexidine than povidone-iodine, it is suggested that similar studies be performed in other hospital wards with more stable patients to obtain more statistically significant results.

Bacterial Sensitivity To Chlorhexidine and Povidone-Iodine Antiseptics Over Time: A Systematic Review and Meta-Analysis of Human-Derived Data

Background Surgical site infection (SSI) is the most common complication of surgery, increasing healthcare costs and hospital stay. Chlorhexidine (CHX) and povidone-iodine (PVI) are used for skin antisepsis, minimising SSIs. There is increasing concern of developing resistance to topical biocides, though clinical implications remain unclear. Outcomes: Determining whether the Minimum Bactericidal Concentration (MBC) for topical preparations of CHX or PVI have changed over time, in microbes relevant to SSI. Methods We included studies reporting the mean bactericidal concentration (MBC) of laboratory and clinical isolates of common microbes to CHX and PVI. Excluding non-human samples and studies using antimicrobial solvents or mixtures with other active substances. MBC was pooled in random effects meta-analyses. Change in MBC over time was explored using meta-regression. Results 79 studies were including, analysing 6218 microbes over 45 years. Most used CHX (93%), with insufficient data for meta-analysis of PVI. There was no change in MBC of CHX to Staphylococci (β 0.12 [-1.13, 1.37]; I2 99%) or Streptococci (β 0.13 [-0.35, 0.62]; I2 97%). Conclusions There is no evidence of reduced susceptibility of common SSI-causing microbes to CHX over time. Providing reassurance that the worldwide guidance that CHX should remain the first-choice agent for surgical skin antisepsis.

In Vitro Efficacy of Cyclosporine A and Various Antiseptics and Antiviral Drugs on Adenovirus Genotype 8, a Common Cause of Epidemic Keratoconjunctivitis

Purpose: To evaluate the in vitro efficacy of cidofovir, ganciclovir, povidone iodine, chlorhexidine, and cyclosporine A on adenovirus genotype 8 Methods: Conjunctival samples were collected from patients with adenoviral conjunctivitis and cultured in A549 cells. Adenovirus diagnosis was confirmed by RT-PCR. For each drug, the 50% cytotoxic concentration (CC₅₀) was determined. Subsequently, the antiviral activity was tested at concentrations below CC₅₀, and the 50% inhibitor concentration (IC₅₀) of drugs was determined.Results: While the IC₅₀ of cidofovir against adenovirus genotype 8 was 3.07 ± 0.8 µM, ganciclovir, povidone iodine, chlorhexidine, and cyclosporine A were not found to be effective against adenovirus genotype 8 at concentrations below the CC₅₀ value.Conclusions: Cidofovir was found effective and the IC₅₀ value was within the ranges in the literature. Ganciclovir and cyclosporine A were found to be ineffective at doses below the cytotoxic dose, povidone iodine and chlorhexidine were found to be highly cytotoxic.

Bilateral, chronic, bacterial conjunctivitis in giant fornix syndrome

Giant fornix syndrome (GFS) results in chronic, relapsing conjunctivitis in elderly patients with enophthalmos and enlarged fornices, in which infectious material collects and perpetuates inflammation. A 98-year-old woman presented with persistent, bilateral, purulent conjunctivitis; corneal epithelial defects and progressive blepharospasm that did not respond to artificial tears, topical antibiotics and steroids and amniotic membrane grafts. Additional findings of deep-set orbits with enlarged upper fornices were diagnostic of GFS. Over the next 2 months, she responded to a combination of topical and systemic antibiotics, autologous serum eye drops, povidone-iodine forniceal rinses, and hypochlorous acid treatment of the eyelashes. GFS is an important diagnostic consideration in elderly patients with chronic conjunctivitis and deep-set orbits.

Studi Kasus: Diagnosis dan Pengobatan Stomatitis pada Kucing Domestik

Stomatitis is an inflammation that occurs in the oral mucosal tissue, characterized by ulcers. This case study aims to diagnose and treat stomatitis in a cat. A 7-month-old female domestic cat weighing 2.7 kg with lethargy, lost of appetite, decreased thirst, and was having sores for 2 days was examined. The cat was examined physically include anamnesis, an inspection of body condition and eating behavior, palpation of the skin, hair, and parts of the body that can be palpated, and auscultation of the thorax and abdomen. The blood sample that was examined includes the erythrocyte count, hemoglobin value, leukocytes count, and their differentials. Physical examination results showed hyperemic gingival, swollen submandibular and retropharyngeal lymphoglandula, and there were multiple ulcers on the lips and tongue. Hematological examination showed thrombocytopenia and monocytosis. The stomatitis was diagnosed to the cat with a good prognosis. Therapy was given for 5 consecutive days in the form of intramuscular injection of Amoxycillin 10 mg/kg BW twice daily, intramuscular injection of diphenhydramine HCl 1 mg/kg BW once daily, subcutaneous injection of 0.5 ml vitamin C once daily, oral administration of 0.5 ml multivitamin twice daily, and povidone-iodine for gargle twice a day applied lightly to the lesion area. Stomatitis in this case study was cured within 5 days by treating with amoxicillin, diphenhydramine HCl, vitamin C, multivitamins, and topical povidone-iodine. Keywords: Amoxicillin; Cat; Stomatitis; Vitamin C. Abstrak Stomatitis merupakan radang yang terjadi pada jaringan mukosa mulut yang ditandai adanya ulser. Studi kasus ini bertujuan melakukan diagnosis dan pengobatan stomatitis pada kucing. Studi kasus ini melaporkan seekor kucing domestik betina umur 7 bulan dengan berat badan 2,7 kg dengan keluhan lesu, tidak ada nafsu makan dan minum, serta menderita sariawan sejak 2 hari sebelum diperiksa. Kucing diperiksa secara fisik meliputi anamnesa, inspeksi terhadap kondisi tubuh dan perilaku makan, palpasi terhadap kulit, rambut, dan permukaan tubuh lainnya, serta auskultasi pada daerah thorax dan abdomen. Sampel darah kucing diperiksa terhadap jumlah eritrosit kadar hemoglobin, jumlah leukosit dan diferensialnya. Hasil pemeriksaan fisik menunjukkan limfoglandula submandibula dan retropharingeal bengkak, gingiva hiperemi serta adanya ulser multiple pada bibir dan lidah. Hasil pemeriksaan darah menunjukkan trombositopenia dan monositosis. Berdasarkan hasil pemeriksaan kucing didiagnosis stomatitis dengan prognosis fausta. Kucing diberi terapi selama 5 hari berupa amoxicilin dosis 10 mg/kg BB dua kali sehari secara intramuskuler, dyphenhidramin HCl 1 mg/kg BB satu kali sehari secara intramuskuler, vitamin C sebanyak 0,5 ml satu kali sehari secara subkutan, multivitamin sebanyak 0,5 ml dua kali sehari secara per oral, dan povidone iodine dua kali sehari dioleskan pada lesi stomatitis. Stomatitis pada kasus ini dapat disembuhkan dalam waktu 5 hari dengan pemberian amoxicilin, dipenhidramin HCl, vitamin C, multivitamin secara sistemik dan povidone iodine secara topikal. Kata kunci: Amoksisilin; Kucing; Stomatitis; Vitamin c