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All Studies   All Outcomes    Recent:   

A Mouthwash with Cetylpyridinium Chloride is reducing salivary SARS-CoV-2 viral load in +COVID-19

Rengifo et al., Revista Estomatologia, doi:10.25100/re.v31i1.12669, NCT04563689
May 2023  
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Hospitalization 68% Improvement Relative Risk Viral clearance 83% Cetylpyridinium Chloride  Rengifo et al.  LATE TREATMENT  DB RCT Is late treatment with cetylpyridinium.. + chlorhexidine beneficial for COVID-19? Double-blind RCT 23 patients in Colombia (July - September 2020) Lower hospitalization (p=0.48) and improved viral clearance (p=0.056), not sig. c19early.org Rengifo et al., Revista Estomatologia, May 2023 FavorsCPC Favorscontrol 0 0.5 1 1.5 2+
RCT 23 patients in Colombia, showing improved viral clearance with cetylpyridinium chloride plus chlorhexidine mouthwash.
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).
risk of hospitalization, 67.6% lower, RR 0.32, p = 0.48, treatment 0 of 12 (0.0%), control 1 of 11 (9.1%), NNT 11, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of no viral clearance, 83.3% lower, RR 0.17, p = 0.06, treatment 1 of 12 (8.3%), control 5 of 10 (50.0%), NNT 2.4, day 5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Rengifo et al., 22 May 2023, Double Blind Randomized Controlled Trial, placebo-controlled, Colombia, peer-reviewed, 13 authors, study period July 2020 - September 2020, this trial uses multiple treatments in the treatment arm (combined with chlorhexidine) - results of individual treatments may vary, trial NCT04563689 (history).
This PaperCetylpyridin..All
A Mouthwash with Cetylpyridinium Chloride is reducing salivary SARS-CoV-2 viral load in +COVID-19. Un enjuague con Cloruro de Cetilpiridinio redujo la carga salival del virus SARS CoV-2 en pacientes con Covid-19
Adolfo Contreras, Rubén León, Andrés Castillo, Vanessa Blanc Pociello, José Luis Bahamón, Yurani Giraldo, Hernando Espinoza, Gerardo Andrés Libreros-Zúñiga, Alejandro Contreras-Parra, Juan Gispert, | Julián Balanta-Melo, | Fausto, Andrés Alban, Beatriz Parra
doi:10.25100/re.v31i1.12669
Aim: The aim of this randomised, double-blind, placebo-controlled pilot clinical trial is to evaluate the capacity of a mouthwash to reduce SARS-CoV-2 viral load in the saliva of patients with COVID-19. Methods: Twenty-three symptomatic SARS-CoV-2-positive outpatients were selected and randomised into two groups and registered at NTC 04563689. Both groups rinsed and gargled for one minute with either distilled water (Placebo) or with 0.05% Cetylpyridinium chloride (CPC) plus 0.12% Chlorhexidine (CHX) mouthwash (PERIOAID Intensive Care  ). Saliva samples were collected before the use of placebo or mouthwash and after 15 minutes and 1 and 2 hours of either of the above treatment. A saliva sample was also taken five days after regular use of placebo or mouthwash twice daily. The virus was detected by qRT-PCR. Results: A great heterogeneity in the viral load values was observed at baseline in both groups for nasopharyngeal and saliva samples. Most of the patients who used the mouthwash (8/12) had a significant decrease in baseline viral load after 15 min (greater than 99% reduction). This inhibitory effect was maintained for up to two hours in 10 of the 12 patients. At five days, SARS-CoV-2 RNA was detected in only 1 patient from the mouthwash group and in 5 from the placebo group. Conclusions: This study points out that a CPC mouthwash can reduce the viral load in saliva of COVID-positive patients. This finding may be important in transmission control of SARS-CoV-2. Nevertheless, the clinical relevance of CPC mouthwash-reduction on SARS-CoV-2 shedding in saliva requires further study. KEY WORDS Antiviral mouthwash; SARS COV-2; Covid-19 patients; salivary viral load. RESMÚMEN Objetivo: El objetivo de este ensayo clínico piloto aleatorizado, doble ciego y controlado con placebo es evaluar la capacidad de un enjuague bucal para reducir la carga viral del SARS-CoV-2 en la saliva de pacientes con COVID-19. Materiales y métodos: Veintitrés pacientes ambulatorios positivos para SARS-CoV-2 sintomáticos fueron seleccionados y aleatorizados en dos grupos y registrados en el NTC 04563689. Ambos grupos se enjuagaron y hicieron gárgaras durante un minuto con agua destilada (placebo) o con cloruro de cetilpiridinio al 0 ,05 % (CPC). ) más enjuague bucal con Clorhexidina (CHX) al 0,12% (PERIOAID Intensive Care ). Se recolectaron muestras de saliva antes del uso de placebo o enjuague bucal y después de 15 minutos y 1 y 2 horas de cualquiera de los tratamientos anteriores. También se tomó una muestra de saliva cinco días después del uso regular de placebo o enjuague bucal dos veces al día. El virus fue detectado por qRT-PCR. Resultados: Se demostró una gran heterogeneidad en los valores de carga viral al inicio del estudio en grupos ambos para muestras de nasofaringe y saliva. La mayoría de los pacientes que usaron el enjuague bucal (8/12) tuvieron una disminución significativa en la carga viral inicial después de 15 minutos (reducción superior al 99 %). Este..
CONFLICT OF INTEREST Authors from Universidad del Valle and from ESE Centro do not have any interest conflict to declare however, the authors associated to Dentaid Research Centre worked within the company that provided the mouthwashes used in this study. SOURCE OF FUNDING The study was funded by investigators of Universidad del Valle, but mouthwashes and oral hygiene kits for patients were donated by Dentaid company.
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Both groups rinsed and gargled ' 'for one minute with either distilled water (Placebo) or with 0.05% Cetylpyridinium chloride ' '(CPC) plus 0.12% Chlorhexidine (CHX) mouthwash (PERIOAID Intensive CareÒ). Saliva samples ' 'were collected before the use of placebo or mouthwash and after 15 minutes and 1 and 2 hours ' 'of either of the above treatment. A saliva sample was also taken five days after regular use ' 'of placebo or mouthwash twice daily. The virus was detected by qRT-PCR.&#x0D;\n' 'Results: A great heterogeneity in the viral load values was observed at baseline in both ' 'groups for nasopharyngeal and saliva samples. Most of the patients who used the mouthwash ' '(8/12) had a significant decrease in baseline viral load after 15 min (greater than 99% ' 'reduction). This inhibitory effect was maintained for up to two hours in 10 of the 12 ' 'patients. 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Povidone-Iodine Demonstrates Rapid in vitro Virucidal ' 'Activity Against SARS-CoV-2, The Virus Causing COVID-19 Disease. Infect ' 'Dis Ther. 2020; 9(3): 669-675.', 'DOI': '10.1007/s40121-020-00316-3'}, { 'key': '182116', 'doi-asserted-by': 'crossref', 'unstructured': 'Bidra AS, Pelletier JS, Westover JB, Frank S, Brown SM, Tessema B. ' 'Comparison of in vitro Inactivation of SARS CoV-2 with Hydrogen Peroxide ' 'and Povidone-Iodine Oral Antiseptic Rinses. J Prosthodont. 2020; 29(7): ' '599-603.', 'DOI': '10.1111/jopr.13220'}, { 'key': '182117', 'doi-asserted-by': 'crossref', 'unstructured': 'Gottsauner MJ, Michaelides I, Schmidt B, Scholz K, Buchalla W, Widbiller ' 'M, et al. A prospective clinical pilot study on the effects of a ' 'hydrogen peroxide mouthrinse on the intraoral viral load of SARS-CoV-2. ' 'Clin Oral Investig. 2020; 24(10): 3707-3713.', 'DOI': '10.1007/s00784-020-03549-1'}, { 'key': '182118', 'doi-asserted-by': 'crossref', 'unstructured': 'Martínez-Lamas L, Diz P, Pérez MT, Del Campo V, Cabrera JJ, López AM, et ' 'al. Is povidone iodine mouthwash effective against SARS-CoV-2? First in ' 'vivo tests. Oral Dis. 2020; 10.1111/odi.13526.', 'DOI': '10.1111/odi.13526'}, { 'key': '182119', 'doi-asserted-by': 'crossref', 'unstructured': 'Seneviratne C J, Balan P, Ko K, Udawatte N S, Lai D, Ng D, et al. ' 'Efficacy of commercial mouth-rinses on SARS-CoV-2 viral load in saliva: ' 'randomized control trial in Singapore. Infection. 2021; 49(2): 305-311.', 'DOI': '10.1007/s15010-020-01563-9'}, { 'key': '182120', 'doi-asserted-by': 'crossref', 'unstructured': 'Amirian ES. Potential fecal transmission of SARS-CoV-2: Current evidence ' 'and implications for public health. Int J Infect Dis. 2020; 95:363-370.', 'DOI': '10.1016/j.ijid.2020.04.057'}, { 'key': '182121', 'doi-asserted-by': 'crossref', 'unstructured': 'Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Müller MA, et al. ' 'Virological assessment of hospitalized patients with COVID-2019. Nature. ' '2020; 581(7809): 465-469.', 'DOI': '10.1038/s41586-020-2196-x'}, { 'key': '182122', 'doi-asserted-by': 'crossref', 'unstructured': 'Wang XW, Li J, Guo T, Zhen B, Kong Q, Yi B, et al. Concentration and ' 'detection of SARS coronavirus in sewage from Xiao Tang Shan Hospital and ' "the 309th Hospital of the Chinese People's Liberation Army. Water Sci " 'Technol. 2005;52(8):213-221.', 'DOI': '10.2166/wst.2005.0266'}, { 'key': '182123', 'doi-asserted-by': 'crossref', 'unstructured': 'Alexandersen S, Chamings A, Bhatta TR. SARS-CoV-2 genomic and subgenomic ' 'RNAs in diagnostic samples are not an indicator of active replication. ' 'Nat Commun. 2020;11(1):6059.', 'DOI': '10.1038/s41467-020-19883-7'}], 'container-title': 'Revista Estomatología', 'original-title': [], 'link': [ { 'URL': 'https://estomatologia.univalle.edu.co/index.php/revista_estomatologia/article/download/12669/15872', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://estomatologia.univalle.edu.co/index.php/revista_estomatologia/article/download/12669/15873', 'content-type': 'text/xml', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://estomatologia.univalle.edu.co/index.php/revista_estomatologia/article/download/12669/15872', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 7, 27]], 'date-time': '2023-07-27T19:33:02Z', 'timestamp': 1690486382000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://estomatologia.univalle.edu.co/index.php/revista_estomatologia/article/view/12669'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2023, 6, 5]]}, 'references-count': 30, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2023, 1, 23]]}}, 'URL': 'http://dx.doi.org/10.25100/re.v31i1.12669', 'relation': {}, 'ISSN': ['2248-7220'], 'container-title-short': 'Rev Estomatol', 'published': {'date-parts': [[2023, 6, 5]]}}
Late treatment
is less effective
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