Why PVP-I?
- Broad-spectrum antiseptic with proven in vitro action against SARS, MERS, and other coronaviruses
- More effective than alternatives like chlorhexidine and benzalkonium chloride
- Already widely used in ophthalmology, orthopedics, and surgical asepsis
SARS-CoV-2 shows high viral loads in the oropharynx and nasopharynx, even in asymptomatic patients. ENT doctors, who often work in close proximity to these areas, are especially at risk.
Study Goals
- Propose routine use of 0.5% PVP-I gargles and nasal drops before ENT procedures
- Evaluate tolerability in patients and healthcare workers
How the Solution Was Used
Formulation:
- Dilute 10% PVP-I: 1 mL in 20 mL of sterile water → 0.5% solution
Application Protocol:
- Nasal drops: 4–5 drops per nostril, 10 minutes before examination
- Gargle: 10 mL mouth rinse and gargle for 30 seconds each
- Frequency:
- For patients: once before procedure
- For healthcare workers: up to 4 times daily, or every 2–3 hours when in frequent contact
Also used for:
- Endoscopy
- Intubation
- Bronchoscopy
- ENT exams and minor surgeries
Key Results
- 315 patients and 17 healthcare workers participated
- No allergic reactions reported
- Only 7 patients reported minor discomfort
- Overall, tolerability was high in both groups
Why This Matters
- Even a few microliters of contaminated saliva can transmit thousands of viral particles
- False negatives in COVID-19 testing can give healthcare workers a false sense of security
- ENT exams are often aerosol-generating, increasing exposure risk
Using 0.5% PVP-I as a mucosal sanitizer could reduce viral load at key entry points, complementing PPE protocols.
Advantages of This Approach
- Proven safety in nasal and oral applications
- Low cost and easy to prepare
- No significant side effects or staining
- Can be used as both prevention and prophylaxis
- Scalable for outpatient clinics, hospitals, and frontline workers
Limitations
- Viral load reduction was not quantified in this study
- Duration of antiseptic effect (approximately 20 minutes) is theoretical, based on prior SARS/MERS studies
- More randomized clinical trials needed to confirm real-world effectiveness
Final Thoughts
The study proposes routine use of 0.5% PVP-I nasal drops and gargle for both patients and ENT staff before examinations and procedures. It’s not a replacement for PPE—but a low-risk, high-reward adjunct to reduce transmission via the mouth and nose.
Until universal rapid testing and vaccines are fully deployed, this simple protocol could provide critical added protection—especially in high-exposure specialties like ENT.
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