Prevention of Upper Respiratory Tract Infections by Gargling: A Randomized Trial

Satomura, Kazunari; Kitamura, Tetsuhisa; Kawamura, Takashi; Shimbo, Takuro; Watanabe, Motoi; Kamei, Mitsuhiro; Takano, Yoshihisa; Tamakoshi, Akiko; Great Cold Investigators-I,

doi:10.1016/j.amepre.2005.06.013

« Previous Next »American Journal of Preventive Medicine
Volume 29, Issue 4 , Pages 302-307, November 2005

Prevention of Upper Respiratory Tract Infections by Gargling:

A Randomized Trial

Kazunari Satomura, MD
- Department of Public Health and International Health, Kyoto University School of Public Health, Kyoto, Japan
Tetsuhisa Kitamura, MS
- Okayama University Faculty of Medicine, Okayama, Japan
Takashi Kawamura, MD
- Kyoto University Health Service, Kyoto, Japan
- Address correspondence and reprint requests to: Takashi Kawamura, MD, Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501 Japan
Takuro Shimbo, MD
- Department of Clinical Epidemiology, Kyoto University Faculty of Medicine, Kyoto, Japan
Motoi Watanabe, MS
- Hokkaido University of Education Faculty of Education, Sapporo, Japan
Mitsuhiro Kamei, MD
- Private practice, Nagoya, Japan
Yoshihisa Takano, MD
- Private practice, Yashiro, Japan
Akiko Tamakoshi, MD
- Department of Preventive Medicine/Biostatistics and Medical Decision Making, Nagoya University Graduate School of Medicine, Nagoya, Japan
Great Cold Investigators-I

Background

Gargling to wash the throat is commonly performed in Japan, and people believe that such hygienic routine, especially with gargle medicine, prevents upper respiratory tract infections (URTIs). Its effectiveness, however, has not been established by clinical trials.

Design

Randomized controlled trial carried out in 2002–2003 winter season and analyzed in 2003 and 2004.

Participants

Healthy volunteers (387) aged 18 to 65 years.

Intervention

Participants were randomly assigned to water gargling, povidone-iodine gargling, and usual care (control). Subjects in the two gargling groups were requested to gargle with water or diluted povidone-iodine at least three times a day. Participants were followed for 60 days.

Main Outcome Measures

The primary outcome measure was first URTI incidence. Severity of URTI symptoms among incident cases was also evaluated. Both outcomes were assessed with a self-administered symptom record. Analyses were performed on an intention-to-treat basis.

Results

A total of 130 participants contracted URTIs. The incidence rate of first URTI was 0.26 episodes/30 person-days among control subjects. The rate decreased to 0.17 episodes/30 person-days in the water gargling group, and 0.24 episodes/30 person-days in the povidone-iodine gargling group. Respective incidence rate ratios against controls were 0.64 (95% confidence interval [CI]=0.41–0.99) and 0.89 (95% CI=0.60–1.33). A Cox regression (proportional hazard model) revealed the efficacy of water gargling (hazard ratio=0.60, 95% CI=0.39–0.95). Even when a URTI occurred, water gargling tended to attenuate bronchial symptoms (p=0.055).

Conclusions

Simple water gargling was effective to prevent URTIs among healthy people. This virtually cost-free modality would appreciably benefit the general population.