Antimicrobial mouthwashes and nasal sprays in the context of COVID-19 (multiple reviews)
What is this? Antimicrobial mouthwashes or nasal sprays have been suggested for use by patients or healthcare workers as a way to reduce the risk of transmission of COVID-19 infection. Some relevant reviews are summarised here. More details, including citations and links to their full text, are available further down this page.
What was found: When the series of three rapid Cochrane Reviews were conducted (searches done on 1 June 2020), the effects of antimicrobial mouthwashes and nasal sprays on patient outcomes and transmission of COVID-19 to healthcare workers were uncertain. However, some ongoing studies were identified and the reviews are being updated.
At the time of the Moosavi review (search done in June 2020), the included in vitro studies showed that some mouthwashes reduced the salivary viral load of a range of viruses but no clinical studies were available and none of the studies investigated SARS-CoV-2.
What are the reviews:
Citation: Burton MJ, Clarkson JE, Goulao B, et al. Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking aerosol‐generating procedures (AGPs) on patients without suspected or confirmed COVID‐19 infection. Cochrane Database of Systematic Reviews. 2020;(9):CD013628.
In this Cochrane rapid review, the authors searched for studies of the effects of antimicrobial mouthwashes and nasal sprays used by patients or healthcare workers before or after aerosol-generating procedures (any medical procedure that causes the patient to produce many small droplets). They did not restrict their searches by date, language or status of publication and did the search on 1 June 2020. They identified no completed or ongoing studies.
Citation: Burton MJ, Clarkson JE, Goulao B, et al. Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when treating patients with suspected or confirmed COVID‐19 infection. Cochrane Database of Systematic Reviews. 2020;(9):CD013626.
In this Cochrane rapid review, the authors searched for studies of the effects of antimicrobial mouthwashes and nasal sprays used by healthcare workers to protect them when treating COVID-19 patients. They did not restrict their searches by date, language or status of publication and did the search on 1 June 2020. They did not identify any completed studies but found two ongoing randomized trials and one ongoing non-randomized study.
Citation: Burton MJ, Clarkson JE, Goulao B, et al. Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed COVID‐19 infection to improve patient outcomes and to protect healthcare workers treating them. Cochrane Database of Systematic Reviews. 2020;(9):CD013627.
In this Cochrane rapid review, the authors searched for studies of the effects of antimicrobial mouthwashes and nasal sprays administered to COVID-19 patients on outcomes for both patients and healthcare workers. They did not restrict their searches by date, language or status of publication and did the search on 1 June 2020. They did not identify any completed studies but found 14 ongoing randomized trials and 2 ongoing non-randomized studies.
Citation: Moosavi MS, Aminishakib P, Ansari M. Antiviral mouthwashes: possible benefit for COVID-19 with evidence-based approach. Journal of Oral Microbiology. 2020;12(1):1794363.
In this rapid review, the authors searched for studies of the effects of mouthwashes on the viral load of viral infections. They did not restrict their searches by date or language of publication and did the search in June 2020. They included five in vitro studies, all of which were from before 2020 and investigated viruses other than SARS-CoV-2.