Commentary - Der Pharmacia Lettre ( 2023) Volume 15, Issue 2
Received: 01-Feb-2023, Manuscript No. DPL-23-92951; Editor assigned: 06-Feb-2023, Pre QC No. DPL-23-92951(PQ); Reviewed: 20-Feb-2023, QC No. DPL-23-92951; Revised: 27-Feb-2023, Manuscript No. DPL-23-92951(R); Published: 06-Mar-2023 , DOI: 10.37532/dpl.2023.15.19
One of the leading causes of death worldwide is respiratory infection. The outbreaks of influenza and the Middle East respiratory syndrome have added to humanity's woes. Interventions such as mask use, social distancing, hand washing, and the use of personal protective equipment by health care professionals have reduced pathogen transmission from infected to healthy individuals. Another intervention is gargling, which is most commonly used by Japanese people to avoid respiratory infections. Gargling is effective in treating Upper Respiratory Infections (URTIs). URTI precedes lower respiratory tract infection; early intervention may prevent complications. The gargling agents in this review are divided into synthetic and natural gargling agents.
Natural agents can cause respiratory infections when gargled with. Tap water, sodium chloride, green tea, essential oils, and other natural agents can be used. A Japanese study was conducted on people who were prone to upper respiratory tract infections and did not gargle on a regular basis. In this study, tap water gargles were found to be 36% more effective than Polyvinylpyrrolidone (PVP-I) gargles in reducing the incidence of upper respiratory tract infection. The subjects in the Japanese study gargled with 20 ml tap water for 15 seconds three times in a row (for a total of 60 ml) and observed the pattern three times per day. The presence of chlorine in tap water may have an impact. The students were randomly assigned to one of four treatment groups: vitamin D3 and gargling, vitamin D3 and no gargling, placebo and gargling, or placebo and no gargling. Gargling with 30 mL tap water for 30 seconds twice daily was performed, while individuals in the vitamin D3 arm were instructed to take one capsule of vitamin D3 weekly for two months (10,000 IU of vitamin D3). In contrast to the Japanese study, vitamin D3 was found to be moderately effective in lowering the risk of URTI, whereas gargling with tap water had no effect. A trial was conducted in the Japanese population to assess the effect of tap water gargling on influenza-like illness. Gargling with tap water did not prevent the flu-like illness.
It has been proposed that Sodium Chloride (NaCl) has the ability to kill all types of viruses. Innate immunity exists in epithelial, fibroblast, and hepatic cells, which convert the chlorine in NaCl to Hypochlorous Acid (HOCl). The use of hypertonic saline nasal irrigation solution reduced the occurrence of upper respiratory infection by 1.9 days, reduced the use of over-the-counter medication by 36%, reduced within-house transmission by 35%, and significantly reduced virus shedding. In comparison to xylitol-containing mouthwash, a 1% solution of sea salt spray and lozenges containing 8.75 mg flurbiprofen were effective in preventing post-operative sore throats. The ineffectiveness of gargles has been attributed to the fact that they are expelled from the mouth, leaving only a small amount of their active ingredient behind, as opposed to lozenges or spray. Another reason for its ineffectiveness could be the nature of the active ingredients in the mouthwash.
Green tea's primary constituents are catechins and theanine. A meta-analysis of five studies, all of which were conducted in the Japanese population, found that gargling with green tea and green tea extracts is effective in the prevention of influenza. Green tea consumption has been shown in observational studies to reduce the incidence of influenza. When compared to a placebo, capsules containing L-theanine and epigallocatechin gallate (equivalent to 10 cups of green tea) reduced influenza symptoms by 32%. Tea extract has been shown to boost immunity and alleviate the symptoms of influenza and urinary tract infections. Six capsules of catechin (378 mg) and theanine (210 mg) were given to health care workers over the age of 20 in a randomised controlled trial. According to the study's findings, catechin and theanine can be used effectively to treat influenza symptoms.
Essential oils have antibacterial properties in the oral cavity. Essential oils, as herbal products, have been shown to be effective against 40 different species of bacteria. The in vitro experiment was carried out on 40 oral bacteria at concentrations ranging from 1-512 micrograms per millilitre. The essential oils were tested on human subjects with a history of clinically recurrent Herpes labialis in a randomised clinical trial. The essential oils reduced viral contamination for 30 minutes. A review of the use of essential oils as mouth rinse concluded that using mouth rinsing products containing essential oils in conjunction with tooth brushing can improve oral health and thus reduce the incidence of respiratory infections. In vitro studies have shown that essential oils are effective against enveloped viruses. The use of essential oil-containing mouthwashes may result in local or systemic allergic reactions.
The gargling agents discussed in this article have beneficial effects and aid in the treatment of respiratory infections. However, the application of each gargling agent varies. In order to know which type of mouth wash or nasal irrigation to use in a specific respiratory infection, health care providers must be informed. Regardless of the benefits, mouthwashes for gargling should be used according to individual needs, or recommendations of physicians and pharmacists should be available for residents of a community experiencing a respiratory infection outbreak. Some gargling agents may cause epithelial damage, so use with caution. Mouthwashes for gargling are not recommended for children under the age of six and should only be used on the teeth.
