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April 7, 1989

Intraperitoneal Povidone-lodine

JAMA. 1989;261(13):1881. doi:10.1001/jama.1989.03420130043016

To the Editor.—  The remarks by Dr Roslyn1 concerning intraperitoneal povidone-iodine (PVP-I) require comment.We have not sought Food and Drug Administration approval for peritoneal irrigation with PVP-I, the active component of our Betadine preparations, and its utility for this purpose remains to be defined. However, we must question portions of Dr Roslyn's response. One reason is the acknowledged difficulty in comparing results of the numerous studies that involved peritoneal lavage with PVP-I, each of which used varying methodologies. Many variables affect these results, including the way systemic antibiotics are used, the thoroughness of local cleansing, the degree of contamination, and the patient's general condition.Nevertheless, a substantial body of literature, both clinical and preclinical, supports intra-abdominal use of PVP-I at appropriate concentrations. Dr Rosyln's reference to an experimental model in which this use was associated with increased mortality concerned a study involving dogs (reference 3). Some investigators have