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Iodine and the Vagina
Vorherr
Antimicrobial effect of chlorhexidine and povidone-iodine on vaginal bacteria.Vorherr H, Vorherr UF, Mehta P, Ulrich JA, Messer RH. J Infect. 1984 May;8(3):195-9. [abstract only]
"The antimicrobial potency
of 4 per cent chlorhexidine gluconate was compared with that of 10 per
cent povidone-iodine (1 per cent free iodine) on the vaginal bacteria
of 150 premenopausal, non-pregnant women. From 30 of the women blood
samples were taken before and at either 15, 30 or 60 minutes after
vaginal cleansing with chlorhexidine for chlorhexidine analysis. Five
minutes after applying either chlorhexidine or povidone-iodine almost
99 per cent of bacteria present on the lateral wall of the vagina were
killed. Chlorhexidine was significantly more effective than
povidone-iodine. Serosanguineous , mucoid or white-yellowish vaginal
discharge did not alter the effectiveness of either antimicrobial
agent. In contrast to povidone-iodine, vaginally applied chlorhexidine
was not absorbed in measurable amounts (sensitivity of detection
method: 0 X 1 mg/l) into the bloodstream. Chlorhexidine may therefore
prove of value for treating vaginitis especially during pregnancy and
also for combating microbes such as Group B streptococci which are
potentially harmful to the newly-born child."
Vaginal absorption of povidone-iodine.Vorherr H, Vorherr UF, Mehta P, Ulrich JA, Messer
RH. [abstract only]
"In 12 nonpregnant women,
total iodine, protein-bound iodine, inorganic iodine, and thyroxine
values were measured in serum before and 15, 30, 45 or 60 minutes
after a two-minute vaginal disinfection with povidone-iodine
(Betadine). Only 15 minutes after application, serum iodine levels
were raised and remained significantly elevated 30, 45 and 60 minutes
after disinfection. Serum concentrations of total iodine and inorganic
iodine were increased up to fivefold to 15-fold, respectively; during
the relative short period of observation, thyroxine levels were not
altered. An overload of iodine can suppress thyroid hormonogenesis,
and the fetal and neonatal thyroid glands are especially sensitive. In
pregnant women, vaginitis should not be treated with povidone-iodine
because of the possible development of iodine-induced goiter and
hypothyroidism in the fetus and newborn. The risk is especially high
when povidone-iodine is used repeatedly."
Wewalka
Efficacy of povidone-iodine vaginal suppositories in the treatment of bacterial vaginosis.Wewalka G, Stary A, Bosse B, Duerr HE, Reimer K. Dermatology. 2002;204 Suppl 1:79-85. [abstract only]
"A prospective, randomized clinical trial was performed to study the efficacy of povidone iodine (Betadine) suppositories for the treatment of bacterial vaginosis (BV) in comparison to capsules containing lactobacilli (Doderlein Med). Seventy patients with BV included in the study were randomly assigned to be either treated with povidone iodine suppositories or lactobacilli. Patients were treated once a day for 5 days. Initial examinations took place on the first day of the study with follow-up examinations on days 8 and 15. The examinations included clinical parameters, patient evaluation, secretion screens, and quantitative and qualitative microbiological tests of vaginal flora. Both treatment groups showed improvement of clinical parameters, condition of secretions and subjective state of health. At day 15 there was a trend towards a better efficacy of the treatment with povidone iodine but this was not significant. However, patients with acute BV treated with povidone iodine had significantly better scores after 15 days. Both treatments were well tolerated. The microbiological examinations showed an increase of the mean number of lactobacilli in the vagina on day 8 after initiation of treatment with lactobacilli, but a decrease on day 15. Contrary to that the lactobacilli counts from patients treated with povidone iodine suppositories decreased after the first week but increased in the second one. Potentially pathogenic germs, e.g. Gardnerella, Bacteroides and Enterobacteria were reduced in a higher extent and with a longer lasting effect after treatment with povidone iodine suppositories than with capsules containing lactobacilli. The results of this study show that native lactobacilli rapidly re-colonize after the antiseptic treatment with povidone iodine. Therefore, there is no need to use lactobacilli in addition. "
Petersen
Local treatment of vaginal infections of varying etiology with dequalinium chloride or povidone iodine. A randomised, double-blind, active-controlled, multicentric clinical study.Petersen EE, Weissenbacher ER, Hengst P, Spitzbart H, Weise W, Wolff F, Dreher E, Ernst U, Della Casa V, Pohlig G, Graf F, Kaiser RR. Arzneimittelforschung. 2002;52(9):706-15. [abstract only]
"This randomised, double-blind, multicentric clinical study compared the efficacy and tolerability of the two vaginal antiseptics, 10 mg dequalinium chloride (CAS 522-51-0, Fluomycin N) and 200 mg povidone iodine (CAS 25655-41-8), in a parallel-group design. A total of 180 patients with vaginal infections of varying etiology participated in this study (bacterial vaginosis, fluor vaginalis, vulvo-vaginal candidiasis, trichomoniasis). Patients were randomly allocated to one of the two treatment groups and were treated once per day for 6 days. Control examinations took place 5 to 7 days after the end of treatment, and 3 to 4 weeks after the first control examination. The total symptoms score, a summary score for the clinical symptoms, discharge, burning, pruritus, redness of vulva/vagina, was defined as primary efficacy parameter. The treatments at the first control examination were compared in the full analysis set using the Wilcoxon-Mann-Whitney U-test, 2-sided, thereby proving equivalence of both treatments at the 5% level. Both treatments strongly improved the symptoms of vaginal infections both on short-term and long-term follow-up. Descriptive analysis of the secondary parameters, vaginal pH, degree of purity of the vaginal flora, and number of lactobacilli in the wet mounts, supported the comparable efficacy of both therapies to restore the vaginal milieu. Analysis of the diagnostic subgroups indicated that irrespective of the diagnosis, both treatments improved the efficacy criteria as observed for the entire population. The global assessment of the therapeutic efficacy by investigators and patients supported the results of the efficacy analysis with good to very good ratings in 70-90% of the cases. A good tolerability of both preparations was observed in this study with a low number of adverse events in the test group (5.8%)."
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