Povidone iodine, 5 to 10% formulations, is considered safe and effective for use in antiseptic handwash.15 Povidone iodine is an iodophor composed of elemental iodine, iodide or triiodide, and a polymer carrier. The amount of free iodine determines its level of antimicrobial activity.16 Iodine molecules rapidly penetrate the microbial cell wall resulting in impaired protein synthesis and disruption of cell membrane. The extent of persistent antimicrobial activity is unclear.2
Antiseptic handwash (Figure 1) removes or destroys transient microorganisms and reduces the resident hand flora.2 It is an acceptable alternative to handwashing when the hands are visibly soiled. However, when the hands are not visibly soiled, an alcohol-based handrub (Figure 2) is recommended.2,13,15 The concomitant use of an alcohol-based handrub and povidone iodine is contraindicated and the use of antimicrobial-impregnated wipes (i.e., towelettes) are not acceptable for antiseptic handwash.
Figure 2. How to Handrub when Hands are not Visibly Soiled?