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.
Targeted administration to the respiratory tract provides treatment directly
to the typical source of initial SARS-CoV-2 infection and replication, and
allows for rapid onset of action, higher local drug concentration, and reduced systemic side effects (early treatment may be more beneficial).
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risk of no viral clearance, 85.1% lower, RR 0.15, p < 0.001, treatment 13 of 93 (14.0%), control 75 of 80 (93.8%), NNT 1.3, oropharyngeal rinse and spray, day 4.
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risk of no viral clearance, 59.9% lower, RR 0.40, p < 0.001, treatment 25 of 66 (37.9%), control 52 of 55 (94.5%), NNT 1.8, oropharyngeal rinse only, day 4.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Huang et al., 30 Apr 2021, Randomized Controlled Trial, USA, peer-reviewed, median age 62.0, 2 authors, study period 20 May, 2020 - 15 December, 2020.
Contact:
drjhuang@gmail.com.
Use of chlorhexidine to eradicate oropharyngeal SARS‐CoV‐2 in COVID‐19 patients
Y Hanna Huang, MD Jong T Huang
Journal of Medical Virology, doi:10.1002/jmv.26954
As public distribution of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is underway, prevention of coronavirus disease 2019 (COVID-19) relies on minimizing spread. In this study, chlorhexidine gluconate was investigated as a topical antimicrobial agent against SARS-CoV-2. This was a randomized, prospective cohort study using chlorhexidine as an oral rinse and posterior oropharyngeal spray in hospitalized COVID-19 patients. The primary outcome was presence or absence of laboratory-confirmed SARS-CoV-2 in the oral and oropharyngeal cavities after 4 days of chlorhexidine use and standard of care (study group) or standard of care only (control group). SARS-CoV-2 was eliminated from the oropharynx in 62.1% of patients who used chlorhexidine as an oral rinse, versus 5.5% of the control group patients. Among patients who used a combination of oral rinse and oropharyngeal spray, 86.0% eliminated oropharyngeal SARS-CoV-2, versus 6.3% of control patients. Chlorhexidine is a simple and safe addition to current COVID-19 prevention guidelines and may play a significant role in reducing disease spread.
CONFLICT OF INTERESTS The authors declare that there are no conflict of interests.
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