Dr Nick Jacobs

A UK ophthalmologist is seeking pharma support to manufacture iodine drops for Covid-associated conjunctivitis and promote them as an alternative to antibiotics.

The use of povidone iodine as a substitute for antibiotics has resurfaced as ophthalmologists seek an efficient treatment for Covid-related eye infections. London-based consultant ophthalmologist Dr Nick Jacobs said he believes there is a strong case for prescribing iodine drops in preference to antibiotics and is seeking a manufacturing partner.

“Povidone iodine is very topical and there is a significant history of using this to treat eye infections, and it’s now being used off-label for Covid conjunctivitis,” he said. “We are all striving to reduce the use of antibiotics and there is a proven route to use this, plus it would be useful as a prophylaxis. The cost savings would be significant and open up opportunities to treat many more patients in third world countries.”

The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) said off-label use of medication is a common and accepted practice where supported by the literature and consensus opinion. “For the treatment of Covid-19-related conjunctivitis in Australia or New Zealand, RANZCO expects that a treating ophthalmologist would choose a treatment strategy based on the evolving international peer-reviewed literature, which could include off-label use of therapeutics,” said RANZCO CEO David Andrews.

Dr Jacobs is seeking approval to use povidone iodine 1.25% as antibiotic in conjunctivitis of all types. “It has largely been ignored by modern medicine and big-pharma,” he said, adding he believes the market potential for ophthalmic drops is enormous. “It’s successful in both bacterial and viral conjunctivitis, with the added advantage that people do not develop resistance. It offers an effective replacement for antibiotics and can be used safely with children.”

Povidone-iodine is one of the most used antiseptics worldwide and is active against a wide variety of organisms, including viruses and fungi. As such, it is used as a topical application before surgery and used in the prevention of neonatal conjunctivitis; it is on the World Health Organisation’s List of Essential Medicines.