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N.Z. Gregori, J.C. Schiffman, D.M. Miller, E.C. Alfonso; Clinical Trial of Povidone–iodine (Betadine) vs Placebo in the Pretreatment of Corneal Ulcers . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2774.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate antimicrobial effectiveness of povidone–iodine (Betadine) in reducing bacterial load of corneal ulcers before patients are given antibiotics. Methods: Patients with corneal ulcers were randomized to Betadine or placebo group. Ulcers were cultured before and after a 10–minute application of 5% Betadine or preservative–free artificial tears. All patients were then treated with standard antibiotic medications. The number of colony–forming units (CFU) before and after Betadine or placebo were compared. Results: Eighteen patients were randomized to Betadine and 17 to placebo group. In the Betadine group 8/18 (44 %) ulcers were culture–positive, either before and/or after pretreatment, and in the control group 9/17 (53%). No statistical difference in CFU change after Betadine versus artificial tears application was detected (P–value=0.33, t–test). In the Betadine group 3/18 (17%) of patients showed improvement, i.e., had fewer colonies after drop application; and in the placebo group, 6/17 (35%) showed improvement, (P=0.26, Fisher’s Exact test.) Conclusions: A single application of 5% Betadine did not reduce the bacterial load of corneal ulcers more than just scraping/rinsing alone. This is likely due to the lack of penetration deep into the corneal stroma and number of organisms present. Other factors may be involved.
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