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Over-the-counter (OTC) nasal sprays effectively reduce the symptoms and duration of respiratory infections in patients with pre-existing conditions or risk factors, results from a study of nearly 14,000 people have revealed.
The study, published in The Lancet Respiratory Medicine on 11 July 2024, involved 13,799 participants recruited from GP practices across the UK between December 2020 and April 2023. All participants had at least one comorbidity or risk factor that increased their risk of adverse outcomes owing to respiratory illness, such as asthma, compromised immunity or heart disease.
Patients in the intervention arm were assigned to a gel-based nasal spray (Vicks First Defence; Procter and Gamble; n=3,448), a saline spray (Sterinase; HL Healthcare; n=3,450), or an online behavioural intervention programme promoting physical activity and stress management (n=3,450). A total of 3,451 patients received standard care.
Results showed that participants who used nasal sprays had significantly shorter illness duration compared to those who received no intervention. People in the standard care group reported a mean symptom duration of 8.2 days, which was reduced to a mean of 6.5 days in those using gel sprays, and 6.4 for those who used saline sprays.
Those assigned to behavioural intervention reported a non-significant reduction of 7.4 days.
The number of antibiotic courses was reduced in all intervention groups, including the behavioural intervention group. The gel spray group had an incidence rate ratio (IRR) — a measure where a figure less than 1.0 shows a reduce incidence compared to controls — of 0.65 [0.50–0.84]; the saline group had an IRR of 0.69 [0.54–0.88] and the behavioural intervention group had an IRR of 0.74 [0.57–0.94].
Lead author Paul Little, professor in primary care research from the University of Southampton, said: “Our results show nasal sprays work extremely well to reduce the duration and severity of respiratory infections, and interference with normal activities, which is particularly important in light of the winter infection surge the UK regularly experiences.
“The finding of a reduction in the use of antibiotics is also potentially very important in the fight against antibiotic resistance, one of the major public health threats of our time”.
Commenting on the study, Darush Attar-Zadeh, clinical fellow respiratory pharmacist at the North West London Integrated Care Board, said: “[The findings are] good news for patients with long-term conditions (including lung disease) on the importance of self-care and preventative medicine.
“This is a large, well-designed study and the cohort of patients across all groups are quite similar. The illness reduction and workdays lost is a great finding,” he said.
“Reducing antibiotic prescribing is also a positive outcome.”
Attar-Zadeh added that “having the OTC sprays easily accessible to patients who can’t afford to buy these items is important”.
“I was quite surprised in the percentage reduction compared with usual care with the two sprays and it’s something I’ll certainly be sharing with my respiratory colleagues to cascade to patients.”
