Povidone iodine gargle and mouthwash

Hassandarvish et al., British Dental Journal volume, doi:10.1038/s41415-020-1794-1

Jun 2020

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In Vitro study showing undiluted PVP-I (1% w/v) achieved >5 log10 reduction in SARS-CoV-2 virus titres at 15, 30 and 60 seconds treatment exposure under both clean and dirty conditions. In contrast, when PVP-I was tested at 1:2 dilution a >4 log10 kill at 15 seconds and >5 log10 kill at 30 and 60 seconds in comparison to control was seen in both clean and dirty conditions.

9 preclinical studies support the efficacy of povidone-iodine for COVID-19:

8 In Vitro studies Anderson, Bidra, Frank, Hassandarvish, Meister, Pelletier, Tucker, Xu

1 In Vivo animal study Gaaloul ben Hnia

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1. Anderson et al., Povidone-Iodine Demonstrates Rapid In Vitro Virucidal Activity Against SARS-CoV-2, The Virus Causing COVID-19 Disease, Infectious Diseases and Therapy, doi:10.1007/s40121-020-00316-3.springer.com, doi.org.

2. Bidra et al., Rapid In-Vitro Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Using Povidone-Iodine Oral Antiseptic Rinse, Journal of Prosthodontics, doi:10.1111/jopr.13209.wiley.com, doi.org.

3. Frank et al., In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2, JAMA Otolaryngol Head Neck Surg, doi:10.1001/jamaoto.2020.3053.jamanetwork.com, doi.org.

4. Gaaloul ben Hnia et al., Intranasal antisepsis to reduce influenza virus transmission in an animal modelhttps://onlinelibrary.wiley.com/doi/10.1111/irv.13035, Influenza and Other Respiratory Viruses, doi:10.1111/irv.13035.wiley.com, doi.org.

5. Hassandarvish et al., Povidone iodine gargle and mouthwash, British Dental Journal volume, doi:10.1038/s41415-020-1794-1.nature.com, doi.org.

6. Meister et al., Virucidal Efficacy of Different Oral Rinses Against Severe Acute Respiratory Syndrome Coronavirus 2, The Journal of Infectious Diseases, doi:10.1093/infdis/jiaa471.oup.com, doi.org.

7. Pelletier et al., Efficacy of Povidone-Iodine Nasal and Oral Antiseptic Preparations Against Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2), Ear, Nose & Throat Journal, doi:10.1177/0145561320957237.sagepub.com, doi.org.

8. Tucker et al., In vitro inactivation of SARS-CoV-2 with 0.5% povidone iodine nasal spray (Nasodine) at clinically relevant concentrations and timeframes using tissue culture and PCR based assays, bioRxiv, doi:10.1101/2021.01.31.426979.biorxiv.org, doi.org.

9. Xu et al., Differential Effects of Antiseptic Mouth Rinses on SARS-CoV-2 Infectivity In Vitro, Pathogens, doi:10.3390/pathogens10030272.mdpi.com, doi.org.

Hassandarvish et al., 26 Jun 2020, peer-reviewed, 8 authors.

In Vitro studies are an important part of preclinical research, however results may be very different in vivo.

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Special care and new environments

S Carr, P Hassandarvish, V Tiong, Malaya, Malaysia A B Sazaly, N A Mohamed, Kuala Lumpur, H Arumugam, A Ananthanarayanan, M Qasuri, Singapore Y Hadjiat

British Dental Journal, doi:10.1038/s41415-020-1786-1

30 and 60 seconds treatment exposure under both clean and dirty conditions. In contrast, when PVP-I was tested at 1:2 dilution a >4 log10 kill at 15 seconds and >5 log10 kill at 30 and 60 seconds in comparison to control was seen in both clean and dirty. Dental practice poses a potential risk of COVID-19 cross-infection among patients, dentists and their assistants through direct exposure to saliva and indirect contact through contaminated instruments. 3 Several associations, including the Australian Dental Association, have recommended using a preprocedural mouthwash with products such as povidone iodine. 4 In our study, we present direct evidence of the virucidal activity of PVP-I gargle and against SARS-CoV-2 in just 15 seconds. In today's scenario, PVP-I gargle and mouthwash could be an adjuvant to PPEs in reducing the risk of COVID-19 transmission in healthcare practices, especially when oral interventions are warranted, such as in dental practice.

References

Challacombe, Kirk-Bayley, Sunkaraneni, Combes, Povidone iodine, Br Dent J

Fallahi H R, Keyhan S O, Zandian, Kim, Cheshmi, Being a front-line dentist during the Covid-19 pandemic: a literature review, Maxillofac Plast Reconstr Surg

Janssen, Eickmann, Zorn, In vitro bactericidal and virucidal efficacy of povidone-iodine gargle/mouthwash against respiratory and oral tract pathogens, Infect Dis Ther

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