Pilot Study to Evaluate the Adjunct Use of a Povidone-Iodine Topical Antiseptic in Patients with Soft Tissue Abscesses

Adriana Segura Olson, Lauren Rosenblatt, Nicholas Salerno, Julie Odette, Ronnie Ren, Tatiana Emanuel, Joel Michalek, Qianqian Liu, Liem Du, Kourosh Jahangir, Gillian R. Schmitz

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Povidone-iodine (PVP-I) antiseptic solutions have been shown to be effective against methicillin-resistant Staphylococcal aureus, a common cause of superficial skin abscesses. Objectives: Our objective was to study the feasibility of using PVP-I as a treatment adjunct in patients with superficial skin abscesses and determine if it confers any benefit over incision and drainage (I&D) alone. Methods: This was a randomized controlled pilot study of adult patients with an uncomplicated skin abscess. Patients were randomized to PVP-I or standard treatment. All patients had I&D and abscess packing. Patients randomized to PVP-I were instructed on daily application of the agent to hands, wound, and surrounding skin with dressing changes. Subjects returned at 48–72 h and 7–10 days and followed-up by phone at 30 days. The primary outcome was clinical cure 7–10 days after I&D. The secondary outcomes were rate of development of new skin lesions and spread in household contacts within 30 days. Results: Clinical cure occurred in 91.3% of patients in the standard group vs. 88.2% of patients in the PVP-I group (difference, 3.1%; 95% confidence interval [CI] −10.7 to 16.8; p = 0.53). There was a significantly higher adverse event rate in the group who received PVP-I (59.6%) vs. standard care (26.5%) (difference 33.1%, 95% CI 13.2–50.2; p < 0.001). Conclusions: There was no difference in clinical cure rates among patients using PVP-I (88.2%) vs. standard care (91.3%) after I&D. There were no major adverse events, but the addition of PVP-I was commonly associated with local skin irritation.

Original languageEnglish (US)
Pages (from-to)405-412
Number of pages8
JournalJournal of Emergency Medicine
Volume56
Issue number4
DOIs
StatePublished - Apr 2019

Keywords

  • abscess
  • antiseptic
  • iodine
  • povidone
  • wound care

ASJC Scopus subject areas

  • Emergency Medicine

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    Olson, A. S., Rosenblatt, L., Salerno, N., Odette, J., Ren, R., Emanuel, T., Michalek, J., Liu, Q., Du, L., Jahangir, K., & Schmitz, G. R. (2019). Pilot Study to Evaluate the Adjunct Use of a Povidone-Iodine Topical Antiseptic in Patients with Soft Tissue Abscesses. Journal of Emergency Medicine, 56(4), 405-412. https://doi.org/10.1016/j.jemermed.2018.12.026