Allergic contact otitis externa due to iodoform in BIPP cavity dressings

Bioactive Bismuth Compounds: Is Their Toxicity a Barrier to Therapeutic Use?

Bismuth compounds are considered relatively non-toxic, with their low solubility in aqueous solutions (e.g., biological fluids) being the major contributing factor to this property. Bismuth derivatives are widely used for the treatment of peptic ulcers, functional dyspepsia, and chronic gastritis. Moreover, the properties of bismuth compounds have also been extensively explored in two main fields of action: antimicrobial and anticancer. Despite the clinical interest of bismuth-based drugs, several side effects have also been reported. In fact, excessive acute ingestion of bismuth, or abuse for an extended period of time, can lead to toxicity. However, evidence has demonstrated that the discontinuation of these compounds usually reverses their toxic effects. Notwithstanding, the continuously growing use of bismuth products suggests that it is indeed part of our environment and our daily lives, which urges a more in-depth review and investigation into its possible undesired activities. Therefore, this review aims to update the pharmaco-toxicological properties of bismuth compounds. A special focus will be given to in vitro, in vivo, and clinical studies exploring their toxicity.

Allergic Reaction to Bismuth-lodoform-Paraffin Paste (BIPP) Following Ear Surgery

Bismuth Iodoform Paraffin Paste (BIPP) impregnated ribbon gauze is one of the most commonly used packs after external and middle ear surgery. Allergic reaction to BIPP is rare. We report two cases of hypersensitive BIPP reaction following tympanoplasty surgery. To our knowledge no such cases have been reported previously in Qatar. We reviewed the literature and discuss the management and its prevention.