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Eligibility and efficacy of a CPC‐ and CHX‐based antiviral mouthwash for the elimination of SARS‐CoV‐2 from the saliva: A randomized, double‐blind, controlled clinical trial

Giulia et al., Journal of Clinical Periodontology, doi:10.1111/jcpe.13905
Dec 2023  
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RCT 20 patients rinsing with CPC-CHX compared with 20 patients rinsing with water, showing no significant difference in short-term viral load via PCR and ELISA.
Results are not clear. Figure 3 shows an increase in ELISA I/T between all time points in both groups, which does not match Figure 4. For example, in Figure 4 I/T decreases for both water and CPC-CHX groups in both the vaccinated and unvaccinated subgroups.
Study covers cetylpyridinium chloride and chlorhexidine.
Giulia et al., 7 Dec 2023, Double Blind Randomized Controlled Trial, Germany, peer-reviewed, mean age 40.2, 9 authors, study period January 2022 - August 2022. Contact: kathrin.becker@charite.de.
This PaperCetylpyridin..All
Eligibility and efficacy of a CPC‐ and CHX‐based antiviral mouthwash for the elimination of SARS‐CoV‐2 from the saliva: A randomized, double‐blind, controlled clinical trial
Brunello Giulia, Wolf Viktoria, Kerberger Robert, Bernhard Michael, Lübke Nadine, Becker Jürgen, Schwarz‐herzke Beryl, Timm Jörg, Becker Kathrin
Journal of Clinical Periodontology, doi:10.1111/jcpe.13905
Aim: This study aimed at investigating the efficacy of a 0.05% cetylpyridinium chloride-0.05% chlorhexidine (CPC-CHX) mouthwash in reducing viral load in the saliva as compared with sterile water. Materials and Methods: Forty SARS-CoV-2 positive patients were asked to dispense 4 mL of saliva. Half the patients rinsed for 60 s with 15 mL CPC-CHX, and the remaining patients rinsed with sterile water (control). Four millilitres of saliva were collected after 15, 30 and 60 min after rinsing. Quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA) specific for SARS-CoV-2 nucleocapsid protein were performed. For ELISA, the intact (representing the active virus) to total virus load (I/T) was calculated. Results: SARS-CoV-2 copy numbers/mL from RT-qPCR tended to decrease in the control group, whereas in the CPC-CHX group, an increase was observed after T30. However, mixed linear model analysis revealed no statistical differences between groups (p = .124), time points (p = .616) and vaccinated or non-vaccinated patients (p = .953). Similarly, no impact of group (p = .880), time points (p = .306) and vaccination (p = .711) was observed for I/T ratio values. Conclusions: Within the limitation of this study, there was no evidence that the intervention reduced salivary SARS-CoV-2 viral load during the course of 60 min. Therefore, commonly used pre-procedural rinsing might not be clinically relevant.
AUTHOR CONTRIBUTIONS Conceptualisation: Giulia Brunello, Jürgen Becker and Kathrin Becker. ACKNOWLEDGEMENT Open Access funding enabled and organized by Projekt DEAL. FUNDING INFORMATION The study was self-funded by the Department of Oral Surgery, University Hospital Düsseldorf (Düsseldorf, Germany). CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest. SUPPORTING INFORMATION Additional supporting information can be found online in the Supporting Information section at the end of this article.
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Late treatment
is less effective
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