A pilot, open labelled, randomised controlled trial of hypertonic saline nasal irrigation and gargling for the common cold

摘要

There are no antivirals to treat viral upper respiratory tract infection (URTI). Since numerous virusescause URTI, antiviral therapy is impractical. As we have evidence of chloride-ion dependent innateantiviral response in epithelial cells, we conducted a pilot, non-blinded, randomised controlled trialof hypertonic saline nasal irrigation and gargling (HSNIG) vs standard care on healthy adults within48?hours of URTI onsetto assess recruitment(primary outcome).Acceptability, symptom durationand viral shedding were secondary outcomes. Participants maintained a symptom diary until wellfortwo days or a maximum of 14 days and collected 5 sequential mid-turbinate swabs to measureviral shedding. The intervention arm prepared hypertonic saline and performed HSNIG. We recruited68 participants (2.6 participants/week; November 2014-March 2015).A participant declined afterrandomisation.Another was on antibiotics and hence removed (Intervention:32,Control:34). Follow updata was available from 61 (Intervention:30,Control:31). 87% found HSNIG acceptable, 93% thoughtHSNIG made a diference to their symptoms. In the intervention arm, duration of illness was lower by1.9 days (p?=?0.01), over-the-counter medications (OTCM) use by 36% (p?=?0.004),transmission withinhousehold contacts by 35% (p?=?0.006) and viral shedding by ≥0.5 log10/day (p?=?0.04).We hence need alargertrialto confrm our fndings.