Effect of Topical Application of Povidone-Iodine on the Number of Bacteria Entering the Lower Respiratory Tract of Intubated Patients: A Randomized Controlled Trial
Abstract
Objective: The aim of the study was to evaluate and compare the efficacy of povidone-iodine (PI) oral care and toothbrushing in reducing the number of viable bacteria in subglottic secretions of intubated patients. Methods: This open-label randomized controlled trial included 20 ICU patients undergoing mechanical ventilation. Patients were assigned to either the PI or the toothbrushing groups. Subglottic secretions were collected immediately before oral care (baseline) and at 1, 2, 3, and 6 hours after the intervention. Viable bacterial counts were quantified using delayed real-time polymerase chain reaction. The Mann-Whitney U test was used for statistical comparison. Results: The PI group showed significant reductions in bacterial counts at 2, 3, and 6 hours after care (p=0.023, 0.002, and <0.001, respectively), whereas the toothbrushing group did not show significant changes. Conclusion: PI oral care effectively reduces viable bacterial load in the lower respiratory tract and may serve as a safe and cost-effective alternative to chlorhexidine for ventilator-associated pneumonia prevention in Japan.
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 20 participants or records.
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