MECHANISM OF ACTION AND CLINICAL APPLICATIONS

PVP-I’s antimicrobial action stems from the release of free iodine, which disrupts microbial proteins and nucleic acids. This broad-spectrum activity encompasses bacteria, fungi, viruses, and protozoa. In first aid, PVP-I is used primarily as a 5% solution to treat minor injuries, making it a valuable tool for preventing infections.²

Beyond basic wound care, PVP-I has demonstrated efficacy in specialised childhood applications. For instance, research on early childhood caries (ECC) highlighted its role in delaying bacterial regrowth. Children treated with quarterly applications of 10% PVP-I following dental rehabilitation experienced significant reductions in Streptococcus mutans levels and no new or recurring caries over a one-year period.³

Another critical application emerged during the Covid-19 pandemic. Low-concentration PVP-I solutions (0.23–1%) demonstrated rapid inactivation of SARS-CoV-2 in vitro within 15-30 seconds. ⁴

SAFETY AND ADVERSE EFFECTS

PVP-I is considered safe when used according to recommended guidelines. Its application should be restricted to intact skin to mitigate risks of systemic iodine absorption.¹ Avoidance on large areas or prolonged use minimises the potential for rare incidents like thyroid dysfunction.⁴ For typical first aid purposes, such risks are negligible.

However, rare adverse effects underscore the need for caution and the importance of monitoring for signs of hypersensitivity, especially in children with potential iodine allergies.

PVP-I VERSUS OTHER ANTISEPTICS

Pharmacists may encounter caregivers opting for alternatives like chlorhexidine, which has a lower risk of skin irritation and systemic absorption issues. However, chlorhexidine’s narrower antimicrobial spectrum makes it less effective against fungi and viruses. PVP-I’s broad efficacy, particularly in cases with viral or fungal risks, reinforces its role as a versatile first aid antiseptic.⁴

PHARMACISTS’ ROLE IN BEST PRACTICES

Pharmacists are pivotal in ensuring PVP-I’s safe and effective application. Recommendations for caregivers should include:

• Preparation: Clean the wound thoroughly to remove dirt and contaminants.¹
• Application: Use a small amount of PVP-I as per the dosing instructions, allowing it to dry before covering with a sterile bandage.¹
• Precautions: Avoid use on mucosal surfaces, animal bites, or deep puncture wounds.¹
• Monitoring: Discontinue use if irritation, redness, or other adverse signs occur, and refer the child for medical attention if symptoms persist.¹

 Pharmacists can also educate caregivers on proper storage and label warnings, emphasising that PVP-I is intended for short-term use only. Caregiver awareness of allergies and hypersensitivity risks helps mitigate adverse outcomes.

 PVP-I remains integral to wound care in children aged two and older, offering broad-spectrum antimicrobial properties with a good safety profile.¹ By equipping caregivers with clear guidance, pharmacists ensure PVP-I is used to its full potential while safeguarding children’s health outcomes.