Research articlePrevention of Upper Respiratory Tract Infections by Gargling: A Randomized Trial
Introduction
Upper respiratory tract infection (URTI) is one of the most common medical problems in the daily lives of otherwise healthy people. In the United States, people experienced 2.5 episodes, on average, every year.1, 2 However, corroborative evidence for URTI prevention is quite scarce. People, therefore, take measures on the basis of their own experience or preferences.
Gargling is generally accepted and strongly recommended as a preventive modality against URTI in Japan. A lot of people use gargle medicines such as povidone-iodine expecting virucidal effects.3, 4 Some simple questionnaire survey and nonrandomized studies suggested that frequent gargling with diluted povidone-iodine would reduce the incidence of URTI or influenza and the following absenteeism from schools or workplaces.5, 6, 7, 8 However, there have been no controlled trials, and it remained unresolved as to whether gargling was really effective.
To answer this simple question, a randomized controlled trial was conducted in community healthcare settings all over Japan.
Section snippets
Study Associates and Participants
In September 2002, authors invited applications for study associates through several relevant mailing lists from the Internet. Eighteen healthcare professionals who agreed with the purpose and protocol of the study were appointed local administrators. From December 2002 through January 2003, healthy adult volunteers were recruited for the study in the local administrators’ areas. The inclusion criteria were both genders, aged 18 to 65 years, and subjectively healthy. The exclusion criteria were
Results
Figure 1 is the flowchart of this study. A total of 387 subjects participated in the study at 18 sites (four in northern Japan, nine in the central region, and five in the western region; two to 52 persons per site) and were randomized. The follow-up period was 60 days between December 2002 and March 2003. Excluded from analysis were two subjects who already suffered from URTI on the first day of intervention, and one subject who did not write in the diary at all (follow-up 99%). Two subjects
Discussion
To our knowledge, this is the first randomized controlled trial to evaluate the effectiveness of gargling for the prevention of URTIs among healthy people. Authors found that simple water gargling would reduce the incidence rate of URTIs during 60 days in the prevalent season by 36%. Water gargling might also decrease supervening bronchial symptoms even if one contracted a URTI.
Whirling water is deemed to wash out pathogens from the pharynx and oral cavity. The incubation time of rhinovirus, a
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