A trial of povidone-iodine (PVP-I) nasal inhalation and gargling to remove potentially pathogenic bacteria colonized in the pharynx

Abstract

OBJECTIVE: Aspiration of potentially pathogenic bacteria (PPB) colonized in the upper airway is a major cause of bacterial pneumonia. We hypothesized that PVP-I nasal inhalation is effective in removing PPB from the upper airway. The aim of this study was to investigate the effectiveness and safety of PVP-I nasal inhalation. METHODS: Patients with asymptomatic PPB (MRSA and/or aerobic GNB i.e. Pseudomonas aeruginosa, Enterobacteriaceae) colonization in the pharynx were enrolled in this study. These patients were divided randomly into two groups as follows: a PVP-I nasal inhalation group (N group) which was asked to inhale 1% PVP-I solution x 2/day nasally by a jet nebulizer and gargling with PVP-I solution x 2/day, and a control group (C group), which was asked to gargle with PVP-I solution x 2/day. The study period was 2 weeks in both groups. RESULTS: Group N consisted of 16 cases, which included 9 (56%) cases with chronic respiratory complications and group C consisted of 14 cases which included 6 (43%) cases with complications. In N and C group, PPB disappearance from the pharynx was observed in 44% and 14% of patients after the study period, respectively. In the patients of group N, without chronic respiratory complication, PPB disappeared in 86% ot the cases. There was no adverse effect correlated with PVP-I nasal inhalation. CONCLUSION: We conclude that PVP-I nasal inhalation is a safe procedure for removing PPB from the upper airway, and this method may contribute to preventing bacterial pneumonia.