カデックス ◊
局所感染コントロールとバイオフィルム対策に
概要
カデックスは、ヨウ素を主薬とした局所抗菌薬です。Perstorp社が開発したカデキソマービーズという特殊な基材は、滲出液の吸収に優れ、粘性壊死組織（スラフ）を吸着・除去します。
また、滲出液の量に合わせてヨウ素を徐々にリリースするドラックデリバリーシステムで、ヨウ素を失活することなく効果的に抗菌作用を発揮します。
1993年に国内販売開始され、カデックスのジェネリック医薬品はありません。バイオフィルムに対する有用性についても広く報告されています。
4つの特長
1.ヨウ素による広い抗菌スペクトル
・ 0.9%濃度のヨウ素
・ ヨウ素を不活化させない構造
2.徐放性ドラッグデリバリー
・ 滲出液の量に応じてヨウ素を放出することで殺菌
・ 持続的な殺菌作用を示す
3.バイオフィルムに対する殺菌作用
・ 吸水力のあるカデキソマービーズがバイオフィルムを脱水してバイオフィルムマトリクスを阻害
・ 露出された細菌をヨウ素が死滅
4.壊死組織の除去
・ 粘性壊死組織（スラフ）を吸着・除去
動画
販売名：カデックス外用散0.9％医療薬品 承認番号：22000AMX01040000
販売名：カデックス軟膏0.9％
医療医薬品 承認番号：21300AMY00072000
販売名：カデックス軟膏分包45mg
医療医薬品 承認番号：22100AMX00241000
販売名：カデックス軟膏分包153mg
医療医薬品 承認番号：2100AMX00243000
手技書・カタログ等はこちらからご覧いただけます。
製品カタログ、製品情報概要
Citations
1. O’Meara S, Al Kurdi D, Ologun Y, Ovington LG. Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2010;(1):CD003557.
2. O’Meara S, Al Kurdi D, Ologun Y, Ovington LG, Martyn St James M, Richardson R. Antibiotics andantiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2014;(1):CD003557.
3. Fitzgerald DJ, Renick PJ, Forrest EC, et al . Cadexomer iodine provides superior efficacy againstbacterial wound biofilms in vitro and in vivo. Wound Repair Regen. 2017;25:13 24.
4. Phillips PL, Yang Q, Davis S, Sampson EM, Azeke JI, Hamad A, Schultz GS. Antimicrobial dressingefficacy against mature Pseudomonas aeruginosa biofilm on porcine skin explants. Int Wound J. 2015;12(4):469 483.
5. Roche ED, Woodmansey EJ, Yang Q, Gibson DJ, Zhang H, Schultz GS. Cadexomer iodine effectivelyreduces bacterial biofilm in porcine wounds ex vivo and in vivo. Int Wound J. 2019;16(3):674 683.
6. Floyer C, Wilkinson JD. Treatment of venous leg ulcers with cadexomer iodine with particularreference to iodine sensitivity. Acta Chir Scand Supp l 1988;554:60 61.
7. Hansson C. The effects of cadexomer iodine paste in the treatment of venous leg ulcers comparedwith hydrocolloid dressing and paraffin gauze dressing. Int J Dermatol. 1998;3:390 396.
8. Harcup JW, Saul PA. A study of the effect of cadexomer iodine in the treatment of venous leg ulcers. Br J Clin Pract. 1986;40:360 364.
9. Holloway GA, Johansen KH, Barnes RW, Pierce GE. Multicenter trial of cadexomer iodine to treatvenous stasis ulcer. West J Med. 1989;151:35 38.
10. Johnson A. A combative healer with no ill effect. IODOSORB in the treatment of infected wounds. Prof Nurse. 1991;7(1): 60, 62, 64.
11. Laudanska H, Gustavson B. In patient treatment of chronic varicose venous ulcers. A randomized trialof cadexomer iodine versus standard dressings. J Int Med Res. 1998;16:428 435.
12. Lindsay G, Latta BD, Lyons KGB, Livingstone ED, Thomson W. A study in general practice of theefficacy of cadexomer iodine in venous leg ulcers treated on alternate days. Acta Ther. 1986;12:141148.
13. Ormiston MC, Fox JA. Controlled trial of IODOSORB. Br Med J. 1985;291:308 310.
14. Skog E, Arnesj ö B, Tro ë ng T, et al . A randomized trial comparing cadexomer iodine and standardtreatment in the out patient management of chronic venous ulcers. Br J Dermatol. 1983;109:77 83.
15. Sundberg J, Meller R. A retrospective review of the use of cadexomer iodine in the treatment ofchronic wounds. Wounds. 1997;9:68 86.
16.Tro ë ng T, Skog E, Arnesj ö B, Gj ö res JE, Bergljung L, Gundersen JEA. A randomised multicentre trial tocompare the efficacy of cadexomer iodine and standard treatment in the management of chronicvenous ulcers in out patients. in Cadexomer Iodine, (eds. Fox, J. & Fisher, H.) 43 50 ( SchattauerVerlag, 1983).
17. Zhou LH, Nahm WK, Badiavas E, Yufit T, Falanga V. Slow release iodine preparation and woundhealing: in vitro effects consistent with lack of in vivo toxicity in human chronic wounds. Br JDermatol. 2002;146:365 374.
18. Hillstrom L. IODOSORB compared to standard treatment in chronic venous leg ulcers a multicenterstudy. Acta Chir Scan Supple. 1988;544:53 56.
19. Moberg S, Hoffman L, Grennert ML, Holst A. A randomized trial of cadexomer iodine in decubitusulcers. J Am Geriatr Soc. 1983;31:462 465.
20. Polignano R, Terriaca P, Rowan S, Pavanelli A. The role of cadexomer iodine in difficult to heal ulcers. Poster presentation at the European Wound Management Association (EWMA), 15 17 September 2005, Stuttgart, Germany.
21. Danielsen L, Cherry GW, Harding K, Rollman O. Cadexomer iodine in ulcers colonised byPseudomonas aeruginosa. J Wound Care. 1997;6:169 172.
22. Schwartz JA, Lantis JC 2nd, Gendics C, Fuller AM, Payne W, Ochs D. A prospective, non comparative,multicenter study to investigate the effect of cadexomer iodine on bioburden load and other woundcharacteristics in diabetic foot ulcers. Int Wound J. 2013;10:193 199.
23. Malone M, Johani K, Jensen SO, et al . Effect of cadexomer iodine on the microbial load and diversityof chronic non healing diabetic foot ulcers complicated by biofilm in vivo. J Antimicrob Chemother. 2017;72:2093 2101.
24. Lantis JC, Schultz G, Edmondson Jones M, et al . Effects of cadexomer iodine on a biofilm in diabeticfoot ulcers: A pilot study. World Union of Wound Healing Societies (WUWHS), 25 29 September 2016,Florence, Italy.
25. Malone M, Schwarzer S. T.I.M.E. to say goodbye to non healing chronic wounds. A case series ofdiabetic foot ulcer management. Smith & Nephew case series. 20092. July 2019.
26. Sandoz H, Swanson T, Weir D, Schultz G. Biofilm based wound care with cadexomer iodine madeeasy. Wounds Int. 2017:10 11.
27. Altenkamper H, Glaser E, Slegmann W. Ulcus Cruris: Cadexomer iodine stimulates wounds healing.Arzliche Praxis. 1985;72:2790 2793.
28. Miller CN, Newall N, Kapp SE. A randomized controlled trial comparing cadexomer iodine andnanocrystalline silver on the healing of leg ulcers. Wound Repair Regen. 2010;18:359 367.
29. Nherera LM, Woodmansey E, Trueman P, Gibbons GW. Estimating the clinical outcomes and costdifferences between standard care with and without cadexomer iodine in the management ofchronic venous leg ulcers using a Markov model. Ostomy Wound Manage. 2016;62:26 40.
30. Maessen Visch MB, de Roos KP. Dutch venous ulcer guideline update. Phlebology . 2014;29(1Suppl):153 156.
31. Steele K, Irwin G, Dowds N. Cadexomer iodine in the management of venous leg ulcers in generalpractice. Practitioner. 1986;230:63 68.
32.Allen J, Huddleston E. Assessment of skin irritation potential of IODOSORB dressing, INADINETM and1 Step Prep Iodine using the SkinEthicTM reconstituted human epidermal model, Data on file.0912024. (2009).
33. Brustolin EV, Skare TL, Nassif PA. Wound healing under the effect of iodine cadexomer in rats. ActaCirúrgica Bras. 2012;27:874 879.
34.Lamme EN, Gustafsson TO, Middelkoop E. Cadexomer iodine ointment shows stimulation ofepidermal regeneration in experimental full thickness wounds. Arch Dermatol Res. 1998;290:18 24.
2. O’Meara S, Al Kurdi D, Ologun Y, Ovington LG, Martyn St James M, Richardson R. Antibiotics andantiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2014;(1):CD003557.
3. Fitzgerald DJ, Renick PJ, Forrest EC, et al . Cadexomer iodine provides superior efficacy againstbacterial wound biofilms in vitro and in vivo. Wound Repair Regen. 2017;25:13 24.
4. Phillips PL, Yang Q, Davis S, Sampson EM, Azeke JI, Hamad A, Schultz GS. Antimicrobial dressingefficacy against mature Pseudomonas aeruginosa biofilm on porcine skin explants. Int Wound J. 2015;12(4):469 483.
5. Roche ED, Woodmansey EJ, Yang Q, Gibson DJ, Zhang H, Schultz GS. Cadexomer iodine effectivelyreduces bacterial biofilm in porcine wounds ex vivo and in vivo. Int Wound J. 2019;16(3):674 683.
6. Floyer C, Wilkinson JD. Treatment of venous leg ulcers with cadexomer iodine with particularreference to iodine sensitivity. Acta Chir Scand Supp l 1988;554:60 61.
7. Hansson C. The effects of cadexomer iodine paste in the treatment of venous leg ulcers comparedwith hydrocolloid dressing and paraffin gauze dressing. Int J Dermatol. 1998;3:390 396.
8. Harcup JW, Saul PA. A study of the effect of cadexomer iodine in the treatment of venous leg ulcers. Br J Clin Pract. 1986;40:360 364.
9. Holloway GA, Johansen KH, Barnes RW, Pierce GE. Multicenter trial of cadexomer iodine to treatvenous stasis ulcer. West J Med. 1989;151:35 38.
10. Johnson A. A combative healer with no ill effect. IODOSORB in the treatment of infected wounds. Prof Nurse. 1991;7(1): 60, 62, 64.
11. Laudanska H, Gustavson B. In patient treatment of chronic varicose venous ulcers. A randomized trialof cadexomer iodine versus standard dressings. J Int Med Res. 1998;16:428 435.
12. Lindsay G, Latta BD, Lyons KGB, Livingstone ED, Thomson W. A study in general practice of theefficacy of cadexomer iodine in venous leg ulcers treated on alternate days. Acta Ther. 1986;12:141148.
13. Ormiston MC, Fox JA. Controlled trial of IODOSORB. Br Med J. 1985;291:308 310.
14. Skog E, Arnesj ö B, Tro ë ng T, et al . A randomized trial comparing cadexomer iodine and standardtreatment in the out patient management of chronic venous ulcers. Br J Dermatol. 1983;109:77 83.
15. Sundberg J, Meller R. A retrospective review of the use of cadexomer iodine in the treatment ofchronic wounds. Wounds. 1997;9:68 86.
16.Tro ë ng T, Skog E, Arnesj ö B, Gj ö res JE, Bergljung L, Gundersen JEA. A randomised multicentre trial tocompare the efficacy of cadexomer iodine and standard treatment in the management of chronicvenous ulcers in out patients. in Cadexomer Iodine, (eds. Fox, J. & Fisher, H.) 43 50 ( SchattauerVerlag, 1983).
17. Zhou LH, Nahm WK, Badiavas E, Yufit T, Falanga V. Slow release iodine preparation and woundhealing: in vitro effects consistent with lack of in vivo toxicity in human chronic wounds. Br JDermatol. 2002;146:365 374.
18. Hillstrom L. IODOSORB compared to standard treatment in chronic venous leg ulcers a multicenterstudy. Acta Chir Scan Supple. 1988;544:53 56.
19. Moberg S, Hoffman L, Grennert ML, Holst A. A randomized trial of cadexomer iodine in decubitusulcers. J Am Geriatr Soc. 1983;31:462 465.
20. Polignano R, Terriaca P, Rowan S, Pavanelli A. The role of cadexomer iodine in difficult to heal ulcers. Poster presentation at the European Wound Management Association (EWMA), 15 17 September 2005, Stuttgart, Germany.
21. Danielsen L, Cherry GW, Harding K, Rollman O. Cadexomer iodine in ulcers colonised byPseudomonas aeruginosa. J Wound Care. 1997;6:169 172.
22. Schwartz JA, Lantis JC 2nd, Gendics C, Fuller AM, Payne W, Ochs D. A prospective, non comparative,multicenter study to investigate the effect of cadexomer iodine on bioburden load and other woundcharacteristics in diabetic foot ulcers. Int Wound J. 2013;10:193 199.
23. Malone M, Johani K, Jensen SO, et al . Effect of cadexomer iodine on the microbial load and diversityof chronic non healing diabetic foot ulcers complicated by biofilm in vivo. J Antimicrob Chemother. 2017;72:2093 2101.
24. Lantis JC, Schultz G, Edmondson Jones M, et al . Effects of cadexomer iodine on a biofilm in diabeticfoot ulcers: A pilot study. World Union of Wound Healing Societies (WUWHS), 25 29 September 2016,Florence, Italy.
25. Malone M, Schwarzer S. T.I.M.E. to say goodbye to non healing chronic wounds. A case series ofdiabetic foot ulcer management. Smith & Nephew case series. 20092. July 2019.
26. Sandoz H, Swanson T, Weir D, Schultz G. Biofilm based wound care with cadexomer iodine madeeasy. Wounds Int. 2017:10 11.
27. Altenkamper H, Glaser E, Slegmann W. Ulcus Cruris: Cadexomer iodine stimulates wounds healing.Arzliche Praxis. 1985;72:2790 2793.
28. Miller CN, Newall N, Kapp SE. A randomized controlled trial comparing cadexomer iodine andnanocrystalline silver on the healing of leg ulcers. Wound Repair Regen. 2010;18:359 367.
29. Nherera LM, Woodmansey E, Trueman P, Gibbons GW. Estimating the clinical outcomes and costdifferences between standard care with and without cadexomer iodine in the management ofchronic venous leg ulcers using a Markov model. Ostomy Wound Manage. 2016;62:26 40.
30. Maessen Visch MB, de Roos KP. Dutch venous ulcer guideline update. Phlebology . 2014;29(1Suppl):153 156.
31. Steele K, Irwin G, Dowds N. Cadexomer iodine in the management of venous leg ulcers in generalpractice. Practitioner. 1986;230:63 68.
32.Allen J, Huddleston E. Assessment of skin irritation potential of IODOSORB dressing, INADINETM and1 Step Prep Iodine using the SkinEthicTM reconstituted human epidermal model, Data on file.0912024. (2009).
33. Brustolin EV, Skare TL, Nassif PA. Wound healing under the effect of iodine cadexomer in rats. ActaCirúrgica Bras. 2012;27:874 879.
34.Lamme EN, Gustafsson TO, Middelkoop E. Cadexomer iodine ointment shows stimulation ofepidermal regeneration in experimental full thickness wounds. Arch Dermatol Res. 1998;290:18 24.