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Home / Equine Research Bank / Vet Ophthalmol / Polyhexanide, Povidone-Iodine, and Hypochlorous Acid Show Hi...
Veterinary ophthalmology2026; 29(1); e70141; doi: 10.1111/vop.70141

Polyhexanide, Povidone-Iodine, and Hypochlorous Acid Show High In Vitro Antimicrobial Efficacy Against Pathogens Commonly Associated With Equine Infectious Keratitis.

Abstract: To determine the in vitro antimicrobial activity of specific antiseptics against common equine ocular surface pathogens. Methods: Staphylococcus aureus (S. aureus) (n = 12), Streptococcus equi subspecies zooepidemicus (S. zooepidemicus) (n = 9), Enterobacter hormaechei (E. hormaechei) (n = 6), and Bacillus cereus (B. cereus) (n = 5) were collected from corneal samples of horses with ulcerative keratitis. Reference strains were included. Minimum bactericidal concentrations (MBC) of polyhexanide, povidone-iodine, and hypochlorous acid were tested using the microdilution method. After incubation with the antimicrobial agent, the inocula were subcultured according to the Clinical and Laboratory Standards Institute guidelines. Colony growth was manually counted and photographically documented. Results: The MBC values of polyhexanide were 0.8-3.2 ppm for S. aureus, 0.8-1.6 ppm for S. zooepidemicus, 1.6-3.2 ppm for E. hormaechei, and 1.6-6.4 ppm for B. cereus. For povidone-iodine, values were 8-32 ppm for S. aureus, 4-16 ppm for S. zooepidemicus, 8-16 ppm for E. hormaechei, and 8-16 ppm for B. cereus. For hypochlorous acid, values were 0.4-6.4 ppm for S. aureus, 0.4-3.2 ppm for S. zooepidemicus, 0.8-1.6 ppm for E. hormaechei, and 1.6-6.4 ppm for B. cereus. The MBC values of methicillin-resistant S. aureus isolates were comparable to those of methicillin-susceptible isolates. Conclusions: All antiseptics are highly efficient against common equine ocular bacterial surface pathogens, in concentrations that are well below those of commercially available products. In accordance with the One Health approach, these findings highlight their potential in treating infectious ocular surface disease either as an alternative or alongside topical antibiotics. Further in vivo and clinical studies are required to investigate the translatability of their in vitro effectiveness to clinic cases.
© 2026 The Author(s). Veterinary Ophthalmology published by Wiley Periodicals LLC on behalf of American College of Veterinary Ophthalmologists.
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Publication Date: 2026-01-19 PubMed ID: 41552904PubMed Central: PMC12814315DOI: 10.1111/vop.70141Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This study evaluated the antibacterial effectiveness of three antiseptics—polyhexanide, povidone-iodine, and hypochlorous acid—against bacteria commonly found in horses with infectious keratitis.
  • The results demonstrated that all three antiseptics showed strong activity at low concentrations, suggesting potential as treatments for eye infections in horses, either alone or with antibiotics.

Background and Purpose

  • Equine infectious keratitis is a serious eye condition in horses involving bacterial infection of the cornea.
  • Standard treatments often use antibiotics, but antibiotic resistance is a growing concern.
  • The study aimed to test whether certain antiseptics, known for their broad antimicrobial properties, are effective in killing key bacterial pathogens responsible for this condition.

Methods

  • Four bacterial species were tested, all isolated from infected horse corneas:
    • Staphylococcus aureus (12 isolates)
    • Streptococcus equi subspecies zooepidemicus (9 isolates)
    • Enterobacter hormaechei (6 isolates)
    • Bacillus cereus (5 isolates)
  • Reference bacterial strains were also included for comparison.
  • The minimum bactericidal concentration (MBC) for each antiseptic was determined using a microdilution method, which involves exposing bacteria to decreasing concentrations of the antiseptics and observing at what concentration bacteria are killed.
  • After incubation with antiseptics, bacterial cultures were subcultured to check for surviving bacteria, following established clinical lab standards.
  • Bacterial colony growth was manually counted and documented photographically.

Results

  • Polyhexanide displayed MBC values ranging approximately from:
    • 0.8 to 3.2 ppm for S. aureus
    • 0.8 to 1.6 ppm for S. zooepidemicus
    • 1.6 to 3.2 ppm for E. hormaechei
    • 1.6 to 6.4 ppm for B. cereus
  • Povidone-iodine had MBC values in the range of:
    • 4 to 32 ppm across the tested bacteria, with S. aureus on the higher end (8-32 ppm), and others mostly 4-16 ppm.
  • Hypochlorous acid showed MBCs roughly between:
    • 0.4 to 6.4 ppm for all bacterial species, indicating strong bactericidal effects at low concentrations.
  • The MBC values for methicillin-resistant S. aureus (MRSA) were similar to those for methicillin-sensitive strains, suggesting these antiseptics are effective even against antibiotic-resistant bacteria.

Interpretation and Significance

  • All three antiseptics demonstrated strong bactericidal activity at much lower concentrations than those found in currently available commercial products.
  • This indicates that polyhexanide, povidone-iodine, and hypochlorous acid are potentially effective treatments for equine infectious keratitis.
  • They might serve as alternatives to antibiotics, which is important in the context of increasing antibiotic resistance.
  • The results align with the One Health approach, which integrates human, animal, and environmental health strategies to combat antimicrobial resistance issues.
  • Effectiveness against both susceptible and resistant strains supports broad utility.

Limitations and Future Directions

  • The study was conducted entirely in vitro (in laboratory conditions), which may not fully replicate the complexity of infections in live animals.
  • In vivo studies and clinical trials in horses are needed to:
    • Confirm safety and efficacy on the ocular surface.
    • Determine appropriate dosing protocols.
    • Evaluate potential side effects or toxicity.
  • Further research could explore how these antiseptics perform in combination with antibiotics or other treatments.

Conclusion

  • The findings support consideration of polyhexanide, povidone-iodine, and hypochlorous acid as effective antimicrobial agents against pathogens causing equine infectious keratitis.
  • They have the potential to improve management of this serious ocular condition and help reduce reliance on antibiotics.
  • Translation of in vitro results to actual clinical use requires additional research focusing on practical treatment effectiveness and safety in horses.

Cite This Article

APA
Stolle LM, Oltmanns H, Meißner J, Heun F, Schieder AK, Wolff HT, Ohnesorge B, Busse C. (2026). Polyhexanide, Povidone-Iodine, and Hypochlorous Acid Show High In Vitro Antimicrobial Efficacy Against Pathogens Commonly Associated With Equine Infectious Keratitis. Vet Ophthalmol, 29(1), e70141. https://doi.org/10.1111/vop.70141

Publication

Veterinary ophthalmology
ISSN: 1463-5224
NlmUniqueID: 100887377
Country: England
Language: English
Volume: 29
Issue: 1
Pages: e70141
PII: e70141

Researcher Affiliations

Stolle, Leonie Maria
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Lower Saxony, Germany.
Oltmanns, Hilke
  • Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Hannover, Lower Saxony, Germany.
Meißner, Jessica
  • Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Hannover, Lower Saxony, Germany.
Heun, Frederik
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Lower Saxony, Germany.
Schieder, Ann-Kathrin
  • LABOKLIN GmbH & Co. KG, Bad Kissingen, Bavaria, Germany.
Wolff, Hinrich Tönjes
  • Department of Ophthalmology, Clinic for Small Animals, University of Veterinary Medicine Hannover, Foundation, Hannover, Lower Saxony, Germany.
Ohnesorge, Bernhard
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Lower Saxony, Germany.
Busse, Claudia
  • Department of Ophthalmology, Clinic for Small Animals, University of Veterinary Medicine Hannover, Foundation, Hannover, Lower Saxony, Germany.

MeSH Terms

  • Animals
  • Horses
  • Biguanides / pharmacology
  • Povidone-Iodine / pharmacology
  • Horse Diseases / microbiology
  • Horse Diseases / drug therapy
  • Hypochlorous Acid / pharmacology
  • Microbial Sensitivity Tests / veterinary
  • Bacillus cereus / drug effects
  • Staphylococcus aureus / drug effects
  • Anti-Infective Agents, Local / pharmacology
  • Keratitis / veterinary
  • Keratitis / microbiology
  • Keratitis / drug therapy
  • Enterobacter / drug effects
  • Streptococcus equi / drug effects

Conflict of Interest Statement

: The authors have not used AI to generate any part of the manuscript. The authors declare no conflicts of interest.

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