Povidone Iodine 0.66% to Fight Pseudomonas aeruginosa in Contact Lens Wearer: A Case Report

Abstract

Contact lens use is often associated with corneal infections. Pseudomonas aeruginosa is the most common cause of contact lens-associated infections. Its treatment is often challenging due to the ability of this opportunistic bacteria to be resistant to antibiotics that are, usually, prescribed empirically. Antiseptic could be an adjunctive therapy aiming to broaden the antimicrobial spectrum. Low concentration povidone iodine has rapid broad-spectrum activity against bacteria including P. aeruginosa, fungi, viruses, protozoa, and biofilms, lack of resistance and efficacy in wound healing process, along with an optimum safety and tolerability profile. The purpose of this case report was to show the effect of 0.66% povidone iodine added to the antimicrobial treatment of a corneal abscess caused by P. aeruginosa in a contact lens wearer. A 25-year-old female, with suspected microbial keratoconjunctivitis was empirically treated with topical antibiotics (gentamicin and moxifloxacin). After a worsening of the corneal abscess, subconjunctival injection of gentamicin was started and, with the aim of broadening the antimicrobial spectrum, 0.66% PVP-I (2 times a day) was added. Based on the antibiogram, registering abundant growth of P. aeruginosa, topical antibiotics were substituted with ciprofloxacin, while PVP-I was maintained until complete recovery. Combined treatment of antibiotics and PVP-I 0.66% was effective, safe, and well tolerated in treating ocular infection caused by P. aeruginosa. PVP-I could be a useful additional therapeutic tool for fighting P. aeruginosa infections, generally resistant to antibiotics, and to prevent clinical worsening pending the correct microbiological diagnosis.