Effect of Oral Application of Povidone-Iodine on the Amount of Viable Bacteria Entering the Lower Respiratory Tract in Intubated Patients With Oral Cancer: A Preliminary Study

One of the causes of ventilator-associated pneumonia (VAP) is the aspiration of fluid-containing pathogenic bacteria into the lower respiratory tract. The purpose of this study was to determine whether oral povidone-iodine (PV-I) application reduces bacterial counts in the fluid on the cuff of an endotracheal intubation tube. Patients intubated and managed with tracheostomy for oral cancer surgery were divided into two groups. The PV-I group received a single topical application of PV-I in the oral cavity. The brushing group underwent tooth brushing with suction and cleaning. Before the intervention, and at one, two, three, and six hours after intervention, samples were taken from the mouth and the cuff to determine viable bacterial counts using the delayed real-time polymerase chain reaction method, which quantifies only viable bacteria. Seven patients in the PV-I group and six in the brushing group were included in the study. The brushing group showed an increase in bacterial counts in both the oral cavity and on the cuff up to six hours post intervention. In contrast, the PV-I group showed significantly lower bacterial counts from one to six hours post intervention, both in the oral cavity and on the cuff. These results indicate that topical PV-I application reduces the number of bacteria entering the lower respiratory tract and may help prevent VAP.