Tuesday, May 5, 2020

Hydrogen Peroxide & Betadine Mouthwash / Gargle and COVID-19

Betadine Gargle & Mouth Wash
Content: 1% W/V of Povidone Iodine

Povidone iodine
Mouth and throat infections, Oral hygiene
Adult: As 1% solution: Rinse or gargle 10 mL undiluted solution with an equal volume of warm water for 30 seconds 4 times daily for up to 14 days, or as directed.
Child: As 1% solution: >6 years Same as adult dose
Betadine Gargle and Mouthwash 10mg/ml Oral Solution
Content: Povidone Iodine 1%

Adults, the elderly and children over 6 years of age: Use undiluted with an equal volume of warm water. Gargle or rinse with up to 10 ml of Betadine Gargle and Mouthwash for up to 30 seconds without swallowing. Repeat up to four times daily, for up to 14 days in a row, or as directed by your doctor or pharmacist. Do not use for more than 14 days.

Must NOT be used in children of 6 years and under.
[Approved July 2019 @ Ireland]


Dosing: Paediatric
Mouth, gum, or dental irritation: Children 2 years and Adolescents:
Oral rinse (1.4%): Topical: 10 mL swished around mouth over affected area for at least 1 minute, then spit out; may use up to 4 times daily after meals and at bedtime
UptoDate: Hydrogen Peroxide


Treatments effective against coronavirus include steam and heat. The virus is susceptible to many active ingredients (AI), such as sodium hypochlorite (0.1%–0.5%), 70% ethyl alcohol, povidone-iodine (1% iodine), chloroxylenol (0.24%), 50% isopropanol, 0.05% benzalkonium chloride, 1% cresol soap, or hydrogen peroxide (0.5%–7.0%), etc. Just like the WHO recommendations for Ebola virus (RG4) disinfection, the environment with spills of blood or body fluids could be cleaned up with 1:10 dilution of 5.25% household bleach for 10 minutes.
Wu et al. The outbreak of COVID-19. Journal of the Chinese Medical Association: Mac 2020 - Vol 83, Issue 3, p217-220.

Preprocedural mouth rinse: previous studies have shown that SARS-CoV and MERS-CoV were highly susceptible to
povidone mouth rinse [25]. Therefore, preprocedural mouth rinse with 0.2% povidone-iodine might reduce the load of
corona viruses in saliva [22,26]. Another alternative would be to use 0.5-1% hydrogen peroxide mouth rinse, as it has non specific virucidal activity against corona viruses [27].


Ather et al. Coronavirus Disease 19 (COVID-19): Implications for
Clinical Dental Care. JOE Vol 46, No. 5, May 2020

Effective disinfectants against coronavirus:

Agent
Concentration
Contact Time Required
Sodium hypochlorite
0.1%
1 min
Ethanol
62-71%
1 min
Hydrogen Peroxide
0.5%
1 min
Povidone Iodine
0.23-7.5%
1 min
Tang & Kam. ATOTW 421 :  Perioperative management of suspected / confirmed cases of COVID-19 (6 April 2020).

Ethanol (78%–95%), iso-propanol (70%–100%), the combination of 45% iso-propanol with 30% n-propanol, glutardialdehyde (0.5–2.5%), formaldehyde (0.7%–1%) and povidone iodine (0.23%–7.5%) readily inactivated coronavirus infectivity by approximately 4 log10 or more
Kampf et al.  Potential role of inanimate surfaces for the spread of coronaviruses and their inactivation with disinfectant agents. Journal of Hospital Infection 104 (2020) 246e251

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