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Povidone iodine |
Alcoholic chlorhexidine |
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General: |
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Ingredients |
Polyvinylpyrrolidone (polymer) Diatomic iodine 10% w/v |
Chlorhexidine gluconate (0.5%) Isopropanol 70% |
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Mechanism |
Oxides proteins, nucleotides |
Both disrupt the cell membrane |
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Antimicrobial effect: |
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Bacteria |
Yes (G+ > G-) |
Yes |
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Viruses |
Yes (less so) |
Yes |
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Fungi |
Yes |
Yes |
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Spores |
Yes |
No |
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Resistance |
No |
Yes |
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Time course: |
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Onset |
Slower |
Faster (alcohol kills quickly) |
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Duration |
Long (releases iodine slowly) |
Long (chlorhex binds epidermis, prevents regrowth) |
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Inactivation by body fluids |
Yes (apply to clean skin only) |
No |
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Efficacy: |
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Surgical site |
Less effective |
More effective (risk ↓~40%) |
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Vascular access site |
Less effective |
More effective (risk ↓~50%) |
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Toxicity: |
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Brain & neuraxis |
Less (but max 0.5% skin prep) |
More |
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Middle ear |
Less |
More |
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Cornea |
Less |
More |
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Mucous membrane |
Less |
More |
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Abdominal viscera |
Less |
More |
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Other AEs: |
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Flammability |
No |
Yes (alcohol). Must allow to dry. |
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Allergy/anaphylaxis |
Less common (to povidone, not iodine) |
More common |
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