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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huang (RCT) 85% 0.15 [0.09-0.25] viral+ 13/93 75/80 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Late treatment 85% 0.15 [0.09-0.25] 13/93 75/80 85% lower risk All studies 85% 0.15 [0.09-0.25] 13/93 75/80 85% lower risk 1 chlorhexidine COVID-19 study Sep 2023 Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Effect extraction pre-specified(most serious outcome) Favors chlorhexidine Favors control
Jun 12
Ting et al., Biomedicines, doi:10.3390/biomedicines11061694 Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review
Systematic review of 14 RCTs, showing significant reductions in short-term viral load with mouth rinses cetylpyridinium chloride, β-cyclodextrin and citrox, hydrogen peroxide, chlorhexidine, povidone-iodine, hypochlorous acid, saline, and..
Sep 8
Hasan et al., European Journal of Dentistry, doi:10.1055/s-0042-1753470 Effects of Chlorhexidine and Povidone-Iodine on the SARS-CoV-2 Load: A Systematic Review and Meta-analysis
Systematic review and meta analysis showing significantly improved viral clearance with both povidone-iodine and chlorhexidine.
Jul 31
Ting et al., International Journal of Translational Medicine, doi:10.3390/ijtm2030030 The In Vitro Virucidal Effects of Mouthwashes on SARS-CoV-2
Review of In Vitro studies of mouthwashes, showing antiviral activity for SARS-CoV-2 with many compounds including PVP-I, cetylpyridinium chloride, chlorohexidine gluconate, dequalinium chloride, benzalkonium chloride, and anionic phthalo..
Jul 29
Natto et al., Medicine, doi:10.1097/MD.0000000000028925 The short-term effect of different chlorhexidine forms versus povidone iodine mouth rinse in minimizing the oral SARS-CoV-2 viral load: An open label randomized controlled clinical trial study
60 patient RCT comparing chlorhexidine, PVP-I, and saline in Saudi Arabia with a single mouth rinse treatment and PCR testing 5 minutes later, showing statistically significant improvement in Ct value for PVP-I. PVP-I showed greater impro..
Jul 28
Fantozzi et al., American Journal of Otolaryngology, doi:10.1016/j.amjoto.2022.103549 Efficacy of antiseptic mouthrinses against SARS-CoV-2: A prospective randomized placebo-controlled pilot study
Mouthrinse RCT in Italy comparing short-term viral load after a single 60 second treatment with povidone-iodine, hydrogen peroxide, chlorhexidine, and saline. The greatest efficacy was seen with povidone-iodine, especially for patients wi..
Jul 21
Ghasemi et al., Eur. J. Gen. Dent., doi:10.1055/s-0042-1747958 Reduction in SARS-CoV-2 Oral Viral Load with Prophylactic Mouth Rinse
RCT 116 patients in Iran, showing lower short term viral load with mouth rinses chlorhexidine, hydrogen peroxide, and povidone-iodine. Chlorhexidine and hydrogen peroxide were the most effective.
Jun 30
Keating et al., NCT04478019 SHIELD Study: Using Naso-oropharyngeal Antiseptic Decolonization to Reduce COVID-19 Viral Shedding (SHIELD)
245 participant chlorhexidine + PVP-I prophylaxis RCT with results not reported over 1 year after completion.
Feb 28
Xie et al., NCT04931004 Oral Rinse to Reduced Expelled Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During COVID-19 Infection
Estimated 90 patient chlorhexidine early treatment RCT with results not reported over 1.5 years after estimated completion.
Jan 8
Mira et al., NCT05543603 Evaluation of the Efficacy of Mouth Rinses With Commercial Mouthwashes to Decrease Viral Load in Saliva in COVID-19 Patients
48 patient chlorhexidine early treatment RCT with results not reported over 1.5 years after completion.
Oct 20
Jacox et al., NCT04584684 Mouth Rinses for Inactivation of COVID-19 (MOR)
129 patient chlorhexidine early treatment RCT with results not reported over 1.5 years after completion.
Apr 30
Huang et al., Journal of Medical Virology, doi:10.1002/jmv.26954 Use of chlorhexidine to eradicate oropharyngeal SARS‐CoV‐2 in COVID‐19 patients
85% improved viral clearance (p<0.0001). RCT 294 hospitalized patients in the USA, showing faster oropharyngeal viral clearance with chlorhexidine. Results were better with a combination of oropharyngeal rinse and posterior oropharyngeal spray compared with the rinse alone.
Mar 17
Elzein et al., Journal of Evidence Based Dental Practice, doi:10.1016/j.jebdp.2021.101584 (date from preprint) In vivo evaluation of the virucidal efficacy of chlorhexidine and povidone-iodine mouthwashes against salivary SARS-CoV-2. A randomized-controlled clinical trial
Small RCT comparing mouthwashing with PVP-I, chlorhexidine, and water, showing significant efficacy for both PVP-I and chlorhexidine, with PVP-I increasing Ct by a mean of 4.45 (p < 0.0001) and chlorhexidine by a mean of 5.69 (p < 0.0001)..
Mar 1
Jayaraman et al., medRxiv, doi:10.1101/2021.02.25.21252488 Povidone iodine, hydrogen peroxide and chlorhexidine mouthwashes reduce SARS-CoV2 burden in whole mouth fluid and respiratory droplets
Study of SARS-CoV-2 burden in whole mouth fluid and respiratory droplets with povidone iodine, hydrogen peroxide, and chlorhexidine mouthwashes in 36 hospitalized COVID-19 patients using PCR and rapid antigen testing. There were significa..
Dec 14
Seneviratne et al., Infection, doi:10.1007/s15010-020-01563-9 Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: randomized control trial in Singapore
Small mouthwash RCT with 4 PVP-I patients and 2 water patients concluding that PVP-I may have a sustained effect on reducing the salivary SARS-CoV-2 level in COVID-19 patients. ISRCTN95933274.
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