Commentary: Addressing the Challenges in Antisepsis: Focus on Povidone Iodine

Topical antimicrobials are essential in wound care as they aid the healing process by preventing and at the same time treating infections in wounds1. Broad spectrum antiseptics with high efficacy towards planktonic and sessile bacterial communities are preferred as wound healing can be delayed by the formation of biofilms often developed by antimicrobial resistant organisms2. Additionally, ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp), which are the leading causes of nosocomial infections across the world, are also becoming multidrug-resistant (MDR)3. The correct use of antiseptics can be tricky, and, in this commentary, an overview of key challenges in antisepsis, namely antimicrobial efficacy, antiseptic resistance, antibiotic and antiseptic cross-resistance, wound healing, cytotoxicity, and tolerability, focusing on povidone-iodine (PVP-I) in comparison with other commonly used antiseptics such as chlorhexidine gluconate (CHG), polyhexanide (PHMB) or octenidine (OCT) is provided.