Antiseptic Mouthwash /​ Pre-Procedural Rinse on SARS-CoV-2 Load (COVID-19) (AMPoL)

Gansky et al., NCT04409873, AMPoL, NCT04409873, Nov 2023
Early treatmentDouble-blind RCT · NCT04409873 · 54 patients · USA
Hydrogen Peroxide for COVID-19
AMPoL Gansky et al. NCT04409873 · November 2023
Outcome
Improvement
Relative Risk · 95% CI
00.511.52+
← Hydrogen
Peroxide
reduces risk
Hydrogen Peroxide
increases risk →
Trial underpowered to detect differences

Hydrogen Peroxide for COVID-19

23rd treatment shown to reduce risk in May 2021, now with p = 0.024 from 8 studies.
Lower risk for viral clearance.

No treatment is 100% effective.
Protocols combine treatments.

Early terminated RCT with very limited information reported in the registry and only one patient showing symptoms. There is not enough information to assess the viral load results in the registry - the protocol indicates right-censoring for patients with undetectable viral load which may be the majority of patients at 4 weeks.
Standard of Care (SOC) for COVID-19 in the study country, the USA, is very poor with very low average efficacy for approved treatments1. Only expensive, high-profit treatments were approved for early treatment. Low-cost treatments were excluded, reducing the probability of early treatment due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.
Study covers hydrogen peroxide and cetylpyridinium chloride.
OutcomeImprovementEffect · pTreatmentControl
risk of no recovery 66.7% lower · RR 0.33 · p = 1.00 66.7% lowerRR 0.33p = 1.00 0 of 6 (0.0%) 1 of 6 (16.7%) treatment 0 of 6 (0.0%), control 1 of 6 (16.7%)NNT 6.0continuity correction due to zero events

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates.

Gansky et al., 18 Nov 2023, Double Blind Randomized Controlled Trial, USA, preprint, 1 author, trial NCT04409873 (history) (AMPoL). Contact: stuart.gansky@ucsf.edu, sepideh.banava@ucsf.edu.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org November 2026 USA Angola Colombia Kenya Mozambique Myanmar South Africa Peru Philippines Vietnam Japan Argentina Nepal Iran Bangladesh Ethiopia Ghana Germany Mexico South Korea United Kingdom Saudi Arabia Algeria Morocco Yemen Poland Uzbekistan India China Venezuela DR Congo Madagascar Thailand Uganda Egypt Nigeria Taiwan Fiji Zambia Bosnia-Herzegovina Jordan Georgia Switzerland Dominican Republic Bolivia Côte d'Ivoire Eritrea Togo Bulgaria Greece Slovakia Iceland New Zealand Trinidad and Tobago Mongolia Czechia Belarus Israel Haiti North Macedonia Hong Kong Qatar Panama Serbia USA favored high-profit treatments.The average efficacy of treatments was very low.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org November 2026 USA Angola Colombia Kenya Mozambique Myanmar South Africa Peru Philippines Vietnam Japan Argentina Nepal Iran Bangladesh Ethiopia Ghana Germany Mexico South Korea United Kingdom Saudi Arabia Algeria Morocco Yemen Poland Uzbekistan India China Venezuela DR Congo Madagascar Thailand Uganda Egypt Taiwan Fiji Zambia Jordan Georgia Switzerland Dominican Rep. Bolivia Côte d'Ivoire Eritrea Togo Sri Lanka Bulgaria Greece Slovakia New Zealand Trinidad and Tobago Mongolia Czechia Belarus Israel North Macedonia Hong Kong Qatar Panama Serbia USA favored high-profit treatments.The average efficacy was very low.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%