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Table of Contents
Year : 2021  |  Volume : 23  |  Issue : 3  |  Page : 126

Povidone–iodine: An essential antiseptic in the COVID-19 pandemic

1 Department of ENT and Head and Neck Surgery, AIIMS, Guntur, Andhra Pradesh, India
2 Department of Dentistry, Dr. Smilez Dental Clinic, Puducherry, India

Date of Submission01-Aug-2021
Date of Decision08-Aug-2021
Date of Acceptance08-Aug-2021
Date of Web Publication05-Oct-2021

Correspondence Address:
Dr. Satvinder Singh Bakshi
Department of ENT and Head and Neck Surgery, AIIMS, Mangalagiri, Guntur - 522 503, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjoh.sjoh_34_21

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How to cite this article:
Bakshi SS, Bakshi S. Povidone–iodine: An essential antiseptic in the COVID-19 pandemic. Saudi J Otorhinolaryngol Head Neck Surg 2021;23:126

How to cite this URL:
Bakshi SS, Bakshi S. Povidone–iodine: An essential antiseptic in the COVID-19 pandemic. Saudi J Otorhinolaryngol Head Neck Surg [serial online] 2021 [cited 2022 Jul 2];23:126. Available from: https://www.sjohns.org/text.asp?2021/23/3/126/327568

The transmission of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus via aerosols has been a cause of concern, especially in specialties such as dentistry and ear, nose, and throat where aerosols are generated in routine examinations and procedures. As a preventive measure, one measure which has come to highlight due to its virucidal activity is povidone–iodine (PI).

PI is a broad-spectrum, water-soluble antiseptic that releases free iodine (I2) as the antimicrobial component. Its importance and use can be gauged from the fact that it is listed on the World Health Organization's list of essential medicines. The mechanism of action of iodine is by binding to the surface proteins of enveloped viruses and destabilizes membrane fatty acids.[1] In povidone–iodine, iodine forms a complex with the synthetic carrier polymer povidone. In an aqueous medium, free iodine is released into solution from the povidone–iodine complex and equilibrium is established, with more free iodine being released from the povidone–iodine reservoir as iodine-consuming germicidal activity proceeds. The maintenance of this equilibrium ensures long-lasting efficacy during bouts of microorganism proliferation, as well as better tolerability for patients due to lower levels of irritation. The formulations which are available have concentrations of 7.5%–10% povidone–iodine (PVP-I) in solution, 1% for oral gargles.

PI has virucidal activity against both enveloped and nonenveloped viruses; its efficacy against other pathogenic coronaviruses (CoV) such as Middle East respiratory syndrome-CoV,[2] SARS-CoV has already been established.[3] SARS-CoV-2 virus was completely inactivated by PVP-I oral antiseptic rinse in vitro, at the lowest concentration of 0.5% and at the lowest contact time of 15 s.[4] Topical PI has also been proven to be useful in reducing viral load in nasal cavities.

The safety and tolerability of PI is excellent, the majority of side effects are related to allergic reaction, irritation, and mild transient burning sensation. A few cases of hypothyroidism have been reported in patients using oral iodine gargles extensively,[5] and therefore, its use in patients with active thyroid disorders, pregnant women, and that undergoing radioactive iodine ablation is generally avoided.

Considering its tolerability, broad spectrum of action, and very little chance of developing resistance, PI continues to be the antiseptic of choice, especially during the current coronavirus pandemic.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Barreto R, Barrois B, Lambert J, Malhotra-Kumar S, Santos-Fernandes V, Monstrey S. Addressing the challenges in antisepsis: Focus on povidone iodine. Int J Antimicrob Agents 2020;56:106064.  Back to cited text no. 1
Kariwa H, Fujii N, Takashima I. Inactivation of SARS coronavirus by means of povidone-iodine, physical conditions and chemical reagents. Dermatology 2006;212:119-23.  Back to cited text no. 2
Eggers M, Eickmann M, Zorn J. Rapid and effective virucidal activity of povidone-iodine products against Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and Modified Vaccinia Virus Ankara (MVA). Infect Dis Ther 2015;4:491-501.  Back to cited text no. 3
Bidra AS, Pelletier JS, Westover JB, Frank S, Brown SM, Tessema B. Comparison of in vitro inactivation of SARS CoV-2 with hydrogen peroxide and povidone-iodine oral antiseptic rinses. J Prosthodont 2020;29:599-603.  Back to cited text no. 4
Sato K, Ohmori T, Shiratori K, Yamazaki K, Yamada E, Kimura H, et al. Povidone iodine induced overt hypothyroidism in a patient with prolonged habitual gargling: Urinary excretion of iodine after gargling in normal subjects. Intern Med 2007;46:391-5.  Back to cited text no. 5


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