A comparative study of a phenol-based mouthwash as a gargle or a spray with a saline gargle.
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Adult↗
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[The effect of gargling documented with a picture in the Lakartidningen in 1940. The article's conclusion: pharyngitis can not be treated with gargle water].
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Anti-Infective Agents, Local↗
[Clinical trial of a solution for mouthwash and gargles. Eludril and pressurized gargle derived from it P.F.5].
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Cellulitis↗
Evaluation of the bactericidal activity of povidone-iodine and commercially available gargle preparations.
OBJECTIVE: Encouragement of gargling is important for the control of opportunistic and community-acquired infections. In hospitals, a povidone-iodine (PVP-I) gargle is used frequently. However, at pharmacies in the community a variety of gargles containing various ingredients are now available. In view of this, we conducted a study to compare the bactericidal activities of a PVP-I gargle with those of other commercially available gargles. In addition, we asked about the feeling after use by questionnaire. At middle schools in our city, we investigated whether the encouragement to use the PVP-I gargle had an effect on the absence rate from school due to common cold and influenza. METHODS: In vitro, using 3 strains of gram-positive and 4 strains of gram-negative bacteria as the test strains, the bactericidal activities of the PVP-I, chlorhexidine gluconate (CHG) and cetylpiridium chloride gargles (CPC) were compared by the contact test method. In vivo, with subjects in groups of 6 each, the reduction rate in the oral bacterial count after gargling as compared to the baseline count before gargling was determined and compared among the 3 gargling agents used. In addition, a questionnaire study was conducted to compare the feeling after use of the 3 gargling agents. Whether the absence rate due to common cold and influenza changed by encouraging the use of the PVP-I gargle was determined by comparing a middle school where the PVP-I gargle was used and other middle schools where it was not. RESULTS: (1) PVP-I killed all the test strains after 30 s of exposure. (2) The mean reduction rate in bacterial count immediately after gargling was 99.4% for PVP-I, 59.7% for CHG and 97.0% for CPC. (3) Findings of the questionnaire study revealed that the PVP-I gargle was evaluated highest in terms of taste, feeling after gargling and odor among all the gargles tested. (4) At the middle school where the use of the PVP-I gargle was encouraged, the absence rate due to common cold and influenza was significantly lower as compared to those at middle schools where another gargle was used. CONCLUSION: Of the 3 gargles tested, PVP-I showed the highest bactericidal rate and the highest reduction rate in oral bacterial count. Encouragement of the use of the PVP-I gargle contributed to the decrease in absence rates due to common cold and influenza, indicating that encouragement of gargling with PVP-I is useful for the prevention of common cold and influenza.
Adolescent↗
Gargling with povidone-iodine reduces the transport of bacteria during oral intubation.
PURPOSE: Nosocomial pneumonia remains a common complication in patients undergoing endotracheal intubation. This study examined the transport of bacteria into the trachea during endotracheal intubation, and evaluated the effects of gargling with povidone-iodine on bacterial contamination of the tip of the intubation tube. METHODS: In the gargling group, patients gargled with 25 mL of povidone-iodine (2.5 mg.mL(-1)). In the control group, patients gargled with 25 mL of tap water. Before tracheal intubation, microorganisms were obtained from the posterior wall of the patient's pharynx using sterile cotton swabs. After anesthesia, all patients were extubated and bacteria contaminating the tip of the tracheal tube were sampled and cultured. RESULTS: Before orotracheal intubation, all 19 patients who gargled with tap water (control group) had bacterial colonization on the posterior walls of the pharynx. This group included five patients who had methicillin-resistant staphylococcus aureus (MRSA) in their nasal cavity preoperatively and MRSA was also detected in the pharynx of four patients. Bacterial colonization was observed in all 19 patients who gargled with povidone-iodine (gargling group) and four patients carried MRSA in their nasal cavity, although no MRSA was detected in the pharynx. In the control group, all the patients had bacterial colonization at the tip of the tube after extubation. Additionally, MRSA was detected in two of the four patients. In the gargling group, povidone-iodine eradicated general bacteria and MRSA colonies in the pharynx before intubation and at the tip of the tube after extubation. CONCLUSION: Gargling with povidone-iodine before oral intubation reduces the transport of bacteria into the trachea.
Anti-Infective Agents, Local↗
[Prevention of stomatitis in patients with acute myelogenous leukemia using PVP-iodine (Isodine) gargle].
From November 1987 to October 1990, we investigated the efficacy of povidine iodine gargle solution (Isodine Gargle) for preventing stomatitis in 26 patients (19 males and 7 females; mean age 53.2 years) with acute myelogenous leukemia (AML). The patients were given a concentrated preparation of the gargle solution which they had to dilute 50 times, and were asked to use it 8 times/day for one year. Twenty patients (76.9%) frequently suffered from stomatitis despite the gargling. Therefore, in the second year they were instructed to use the gargle solution at a higher concentration (30-fold dilution). On the third year, they were asked to increase the frequency of gargling to 10 times/day; this resulted in a significant decrease in frequency of the episodes of stomatitis. Severe and painful stomatitis no longer occurred. Gargling with povidine iodine gargle solution was thus considered effective for preventing stomatitis in AML patients.
Adult↗
Effects of amphotericin B gargles on oral colonization of Candida albicans in asthmatic patients on steroid inhalation therapy.
BACKGROUND: Early use of inhaled steroids is recommended for bronchial asthma. The side effects are rare, but oral discomfort and candidiasis are clinically important complications. Most previous studies reported that the use of spacer and water gargling was necessary to prevent oral complications. However, in some patients, this may fail to prevent such complications. OBJECTIVE: To compare the effects of water gargling with those of amphotericin B, in the prevention of oral complications in asthmatics using inhaled steroids. METHODS: Pharyngeal swab samples were obtained aseptically from the posterior pharyngeal wall of 128 asthmatics who have been using inhaled steroids (beclomethasone dipropionate) for more than 1 year. The amount of Candida albicans in cultured swabs was evaluated based on the following criteria: oral symptoms, method of gargling, dose of inhaled steroids, type of spacer and serum cortisol level. RESULTS: The number of isolated C. albicans was significantly higher in asthmatics with oral symptoms than in those free of symptoms. It was also significantly higher in patients who gargled with water or 1,000 times dilution than in those who gargled with 100 or 50 times dilutions of amphotericin B. Moreover, it was significantly higher in patients with low levels of serum cortisol than in those with normal serum cortisol. CONCLUSION: We demonstrated that at least in a subgroup of asthmatics using steroid inhalers, gargling with water or even weak concentrations of amphotericin B does not prevent colonization of the throat with C. albicans. This group at high risk of developing oral candidiasis should gargle with amphotericin B at concentrations higher than 100 times dilution that can prevent clinically detectable oral candidiasis.
Administration, Oral↗
[Clinical availability of the herbal medicine, SYOUSAIKOTOU, as a gargling agent for prevention and treatment of chemotherapy-induced stomatitis].
The stomatitis accompanying chemotherapy reduces a patient's QOL. Many reports have suggested that some kinds of gargling agents for oral mucositis shorten the duration and severity of symptoms. This study tested the prevention and efficacy against stomatitis of a herbal medicine (Syousaikotou) as a gargling agent for patients receiving chemotherapy. Compared to gargling with providone-iodine and amphotericin B, the Syousaikotou gargle showed a significantly decreased incidence of stomatitis, and a painkilling effect. Stomatitis occurred in about 17.4% among 23 chemotherapy cycles with the Syousaikotou gargle, against about 40.8% among 71 chemotherapy cycles without the Syousaikotou gargle. Among the patients suffering stomatitis pain after 22 chemotherapy cycles, the painkilling effect was seen to be 76.2%, and continues for about 2 hours. Critical side effects were not seen, but in 4 cases there were complaints about foul smells, such as oil and grass smells. Syousaikotou gargle was considered to be one of the useful methods against the stomatitis prevention and sharp pain mitigation from the chemotherapy.
Adult↗
Efficacy of throat gargling for detection of group a beta-hemolytic streptococcus.
The purpose of our study was to investigate the suitability of throat gargling with sterile saline as an alternative method to throat swabs for detection of group A beta- hemolytic streptococcus (GAS). Throat specimens were obtained from 601 cases belonging to different age groups. Sterile Dacron swabs and gargle residue were first streaked on the side of a 5% sheep blood agar plate to which a 0.04 U bacitracin disk had been applied, and then 1.25 mg trimethoprim and 23.75 mg sulphamethoxazole were added to the plate. After incubation, beta-hemolytic colonies were classified serologically by latex agglutination. GAS was detected in both throat swabs and throat gargle specimens in 49 cases, but GAS was also detected in 12 throat swabs from patients with culture-negative gargles and in 8 gargle specimens from subjects in whom throat swabs were culture negative. The strength of agreement was evaluated by calculating the kappa coefficient (K = 0.82, P = 0.000). The sensitivity, specificity, positive predictive value, and negative predictive value of throat gargle specimens were 80.3, 98.5, 85.9, and 97.8%, respectively. Although the conventional throat swab culture remains the gold standard, the throat gargle method is a quick, safe, and easy method for detection of GAS that serves as an effective alternative to throat swab culture.
Female↗
[Isolation of alpha-streptococci with inhibitory activity against pathogens, in the oral cavity and the effect of tobacco and gargling on oral flora].
We investigated the distribution of oral alpha-streptococci with inhibitory activity against pathogens, which compose an oral defense mechanism. Detection rate of alpha-streptococci with inhibitory activity against S. pyogenes and S. aureus derived from the tonsil was higher than in other portions, the tongue, cheek, gingiva, or saliva. It has suggested that tonsillar bacterial flora are mainly a defense mechanism. The oral flora in healthy smokers was compared with healthy non-smokers to investigate the influence of tobacco on oral bacterial flora. The results showed that the detection rate of S. aureus in smokers was higher while that of alpha-streptococci with inhibitory activity against S. aureus was lower. However, the detection rate of alpha-streptococci with inhibitory activity against S. pyogenes in smokers was as high as in non-smokers. It is suggested that it was easy for S. aureus to adhere to the oral mucosa in smokers, and was considered to influence the strain which produces beta-lactamase for medical treatment. We investigated the influence of gargling on oral bacterial flora by comparing the amount of bacteria before and after gargling with popidine-iodine gargle and saline solution. It was shown that alpha-streptococci, a main component of normal oral flora were decreased after gargling in both smokers and non-smokers. Furthermore, it was shown that group A Streptococcus was not decreased after gargling, and it was concluded that use of gargle medicinal mouth wash in bacillus carriers should be studied further.
Adult↗
Detection of meningococcal carriage by culture and PCR of throat swabs and mouth gargles.
The standard method for detecting meningococcal carriage is culture of throat swabs on selective media, but the levels of carriage determined depend heavily on the skills of the individuals taking the swab and interpreting the cultures. This study aimed to determine the most sensitive detection method for meningococcal carriage. Throat swabs and saline mouth gargles, obtained from 89 university students, were processed in parallel by conventional culture and TaqMan ctrA PCR. Carriage of meningococci, as detected by the combined methods, was 20%. The sensitivities of throat swab culture, throat swab PCR, gargle culture, and gargle PCR were 72, 56, 56, and 50%, respectively, and the probabilities that these techniques would correctly identify the absence of carriage (negative predictive value [NPV]) were 93.4, 89.9, 89.9, and 88.8%. Culturing both throat swabs and gargles increased the NPV to 98.6%. The further addition of throat swab PCR increased this to 100%. Testing gargles by both culture and PCR was as sensitive as testing throat swabs by both methods, suggesting that gargles may be a suitable alternative for large-scale screening studies when throat swabs are difficult to obtain, although they required more lengthy laboratory processing. PCR was a useful adjunct to culture for detecting nasopharyngeal carriage, but it failed to detect some nongroupable strains. For maximum sensitivity, a combination of techniques was required. This study indicates the confidence with which health care professionals involved in meningococcal screening can regard laboratory results.
Adult↗
Prevention of respiratory infections by povidone-iodine gargle.
Bacterial attachment to host cells is the initial step in the pathogenesis of infection. Our studies and those of others also showed that there is a significant correlation between the attachment of bacteria to human pharyngeal epithelial cells and the occurrence of respiratory tract infections. We identified the receptor on human pharyngeal epithelial cells which mediate binding of Moraxella catarrhalis and Haemophilus influenzae. In an attempt to prevent occurrence of infections, the effects of povidone-iodine gargling on the incidence of respiratory infections were investigated. The subjects included a total of 23 adult patients, both males and females, with chronic respiratory diseases showing repeated infections. Patients were asked to gargle more than 4 times/day with povidone-iodine gargle over extended periods of time, i.e. from several months up to over 2 years. The incidence of episodes of acute exacerbation of chronic respiratory infections decreased significantly when compared with that before use of povidone-iodine gargle. Episodes of infections with Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA) and H. influenzae were reduced by about 50%. Results of this study suggest that povidone-iodine gargle is effective in providing a significant reduction in the incidence of acute exacerbations of chronic respiratory disease. We assume that the colonized bacteria were destroyed and thus infection could not occur. Therefore, povidone-iodine gargle may be used in these patients as a preventive therapy. Further studies are needed to find out the mechanism of action of this drug for the prevention of respiratory tract infections.
Adult↗
[Antibacterial efficacy of some gargles in vivo (author's transl)].
Commercially available gargles containing (hexetidin 0.1%, dequaliniumchloride 0.01%, benzydamin 0.15%) or not containing (OdolTM 0.5%) antibacterials as well as hydrogen-peroxide (3% ml/ml) and aqua dest. as a control tested for their antibacterial efficacy in vivo by applying them for 30 s. Standardized mouth- and throat-washings of 15 volunteers were examined for their aerobic viable counts before as well as 5 and 60 min after gargling. The 5-minutes values (tab. 1) indicated only hexetidin to reduce the oro-pharyngeal flora significantly though not very profoundly by 0.95 orders of magnitude. Usage of the other gargles caused only log reductions of 0.16 to 0.39, aqua dest. such of 0.23. Sixty minutes after treatment (tab 2.) there was still a small but significant reduction of 0.61 log units demonstrable with hexetidin and the viable counts after treatment with hydrogen-peroxide were 0.31 log units below the baseline. The log reductions as assessed with the other gargles ranged 0.0 to 0.18. It is concluded that the favourable therapeutic effects observed clinically with many "antiseptic" gargles with infections of the upper respiratory tract are not based on the antibacterial efficacy of such preparations.
Anti-Infective Agents, Local↗
[A questionnaire survey to evaluate the efficiency of gargling].
The purpose of the study is to evaluate the efficacy of gargling in treating colds which were self-reported by subjects. Workers in a foundry affiliated with a motor corporation were subject to monthly questionnaire surveys from January to March, 1994. They were assigned to the intervention group or to the non-intervention group as controls. The subjects in the intervention group were guided but not enforced to gargle with a remote foot pedal-operated gargling apparatus 3 times during daily work over a 3-month period. Statistical analysis of all data from questionnaires was done by chi-square test or Fisher's exact probability test with 2 x 2 (partially m x 1) correlation tables. The occurrence rate for colds based on the self-reported questionnaire was significantly lower in the intervention group with the significantly higher gargling compliance rate than in the non-intervention group throughout the study period. The rate of sick leave in the intervention group, as well as that of medication, also tended to be lower than in the control group. The results presented suggest that the rate of gargling compliance will be an important factor in the prevention of colds and in health care in a collective such as a workshop or a school.
Adult↗
Systemic cardiovascular and metabolic effects associated with the inhalation of an increased dose of albuterol. Influence of mouth rinsing and gargling.
We designed this investigation to assess the occurrence of systemic beta adrenergic side effects associated with the inhalation of an increased dose of the beta2 receptor agonist albuterol. Since therapeutic aerosols delivered by metered dose inhaler (MDI) are preferentially deposited in the mouth and pharynx, we wished to determine whether mouth rinsing and gargling with water might reduce the magnitude of such side effects by partially removing oral and pharyngeal drug residues. Serum glucose, insulin and potassium concentrations, forced expiratory volume in one second (FEV1), heart rate (HR), and blood pressure (BP) were measured as parameters of beta-adrenergic stimulation. Each of eight nonmedicated mild asthmatic patients was studied on two separate days after an overnight fast. Measurements were obtained twice before and then repeatedly at various times up to three hours after inhalation of ten albuterol doses (total dose approximately 1 mg) delivered by MDI. On either day the patient did, or did not, rinse the mouth and gargle after drug inhalation. Aerosol-administered albuterol significantly increased HR, FEV1, systolic BP and serum concentrations of glucose and insulin and lowered diastolic BP as early as five min after inhalation, indicating early systemic drug absorption. Peak changes in all measured parameters were observed within 30 min after treatment. Mouth rinsing and gargling removed 24 +/- 11 percent of the total albuterol dose delivered, but did not lower the magnitude or shift the time course of these side effects or bronchodilation. Our data suggest that cardiovascular and metabolic side effects are associated with the inhalation of an increased dose of albuterol and that mouth rinsing and gargling are not effective in reducing the magnitude of these systemic effects.
Adult↗
Thyroid function in nurses: the influence of povidone-iodine hand washing and gargling.
The effect of povidone-iodine (PVP-I) hand washing and gargling on thyroid function was assessed. In 16 nurses using PVP-I products and 16 control subjects, serum inorganic iodine levels and thyroid functions were investigated. The status of PVP-I use was also surveyed in the nurses. Clinical symptoms considered to be attributable to thyroid dysfunctions were seen in none of the subjects, nor was a goiter observed in any of the subjects. In nurses, serum inorganic iodine levels were slightly increased as compared to those in the control subjects, although the difference was not significant. The iodine incorporated during working hours of nurses appears to be attributable to gargling rather than to hand washing. The long-term use of PVP-I for gargling should be avoided by (1) people with a high risk of developing thyroid dysfunction due to the excessive intake of iodine, (2) pregnant women and (3) breast-feeding mothers.
Adult↗
[A study of therapeutic efficacy of Koukangning gargle in the treatment of oral mucositis].
A study of therapeutic efficacy was carried out in 118 patients with oral mucositis (recurrent oral aphthous ulceration, erosive lichen planus, herptic stomatitis and infectious oral mucosal hematoma) at random. As a topical medication, Koukangning gargle was applied to 59 patients of the experimental group, 29 patients of the control group 1 applied Dobell's solution to rinse their mouths, and 30 patients of the control group 2 applied Koutai solution. A satisfactory result was observed in the experimental group, its effectiveness and effective rates rose more than those of control group 1 at both treatments for 3 days and 6 days. Between the two groups, there were markedly significant difference (P < 0.005, P < 0.01, P < 0.005, P < 0.005). Koukangning gargle was nontoxic and no side-effects in the clinical tests. Its efficacy was no significant difference compared with the control group 2. Experimental study demonstrates that it possesses anti-inflamation effect and excellent antibiotic effect, therefore it is a new gargle for rinse mouth combined traditional Chinese medicine with Western medicine.
Anti-Infective Agents, Local↗
[Prophylactic effect of black tea extract as gargle against influenza].
We examined whether gargling with black tea prevents influenza infection. Tests were carried out during a five month period (October 1992 to March 1993). The control group that followed their normal daily routine, whereas the test group that gargled with 0.5 w/v% black tea extract twice daily (at 8 a.m. and 5 p.m.). Influenza viruses were isolated from influenza patients and an antigen analysis was carried out. As a result, two strains of influenza A viruses (H3N2) and ten strains of B virus were detected. An HI test was done using paired sera of the control group and the test group. The HI titers raised a four fold or greater in 48.8% (61/125) in the control group and 35.1% (35/134) in the test group. There was a significant difference (p < 0.05) between the control and test groups. These results indicate that black tea extract is effective as a prophylactic agent against influenza infection.
Humans↗