{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:13:14Z","timestamp":1785420794502,"version":"3.56.0"},"reference-count":36,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000053","name":"National Eye Institute","doi-asserted-by":"publisher","award":["UG1EY033284, R34EY022368"],"award-info":[{"award-number":["UG1EY033284, R34EY022368"]}],"id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001818","name":"Research to Prevent Blindness","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001818","id-type":"DOI","asserted-by":"publisher"}]},{"name":"All May See Foundation"},{"name":"Peierls Foundation"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2026,5,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      The aim of this study was to determine the antiamoebic efficacy of povidone-iodine when used as an adjunct to topical biguanide therapy for\n                      <jats:italic toggle=\"yes\">Acanthamoeba<\/jats:italic>\n                      keratitis. Patients with smear- or culture-positive\n                      <jats:italic toggle=\"yes\">Acanthamoeba<\/jats:italic>\n                      keratitis received topical chlorhexidine 0.04%, half-hourly for 2 days, then hourly for days 3\u20136, then eight times per day for days 7\u201328. Participants were randomized in a 1:1 ratio to receive either adjunctive topical povidone-iodine at the same frequency as chlorhexidine or no additional therapy (i.e., control group). Povidone-iodine was initially administered as a 2.5% solution but was reduced to a 1% solution after several reports of intolerance. The primary outcome was\n                      <jats:italic toggle=\"yes\">Acanthamoeba<\/jats:italic>\n                      growth from the culture of corneal scrapings at 1, 2, and 4 weeks after randomization, as assessed by laboratory staff masked to treatment allocation. Of 49 patients enrolled, 25 were randomized to adjunctive povidone-iodine (mean age 48 [SD 16] years; 32% female) and 24 to control (mean age 43 [15] years; 33% female). Four (16%) participants discontinued 2.5% povidone-iodine prematurely due to intolerance. The proportion of participants with a positive culture during the initial 4 weeks of antiamoebic treatment was not significantly different in the povidone-iodine group (6\/18 [33%] at 4 weeks) and control group (5\/16 [31%] at 4 weeks) (RR 0.90, 95%CI: 0.35\u20132.29;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.82). When used as an adjunctive to standard biguanide therapy, povidone-iodine did not markedly accelerate the clearance of\n                      <jats:italic toggle=\"yes\">Acanthamoeba<\/jats:italic>\n                      organisms from the corneal surface over the initial month of therapy.\n                    <\/jats:p>\n                    <jats:p>\n                      This study is registered with ClinicalTrials.gov as\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT03484507\" xlink:type=\"simple\">NCT03484507<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.01512-25","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T12:00:36Z","timestamp":1774958436000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Adjunctive povidone-iodine for\n                    <i>Acanthamoeba<\/i>\n                    keratitis: a randomized trial"],"prefix":"10.1128","volume":"70","author":[{"given":"Revathi","family":"Rajaraman","sequence":"first","affiliation":[{"name":"Cornea Department, Aravind Eye Hospital","place":["Coimbatore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabell","family":"Kassaye","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Francis I Proctor Foundation, University of California","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sankalp S.","family":"Sharma","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05vg07g77","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Cornea and Refractive Surgery, Aravind Eye Hospital","place":["Madurai, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. Venkatesh","family":"Prajna","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05vg07g77","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Cornea and Refractive Surgery, Aravind Eye Hospital","place":["Madurai, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prajna","family":"Lalitha","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Aravind Eye Hospital","place":["Madurai, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arunkumar","family":"Panigrahi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05vg07g77","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Cornea and Refractive Surgery, Aravind Eye Hospital","place":["Madurai, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram","family":"Rammohan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05vg07g77","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology, Aravind Eye Hospital","place":["Coimbatore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krisianne M.","family":"Aromin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Francis I Proctor Foundation, University of California","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Cook","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Francis I Proctor Foundation, University of California","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8813-3171","authenticated-orcid":true,"given":"Travis C.","family":"Porco","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Francis I Proctor Foundation, University of California","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Ophthalmology, University of California","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8216-0240","authenticated-orcid":true,"given":"Thomas M.","family":"Lietman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Francis I Proctor Foundation, University of California","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Ophthalmology, University of California","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerami D.","family":"Seitzman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Francis I Proctor Foundation, University of California","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Ophthalmology, University of California","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7118-1457","authenticated-orcid":true,"given":"Jeremy D.","family":"Keenan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Francis I Proctor Foundation, University of California","place":["San Francisco, USA"]},{"id":[{"id":"https:\/\/ror.org\/043mz5j54","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Ophthalmology, University of California","place":["San Francisco, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2009.06.009"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-6976.2006.00023.x"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2007.08.040"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2023.09.031"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e31820f7763"},{"key":"e_1_3_4_7_2","first-page":"1059","article-title":"A clinicopathologic study of in vitro sensitivity testing and Acanthamoeba keratitis","volume":"35","author":"Elder MJ","year":"1994","unstructured":"Elder MJ, Kilvington S, Dart JK. 1994. 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