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The study led by the University of Southampton in collaboration with the University of Bristol and funded by The National Institute for Health and Care Research (NIHR), is published in The Lancet Respiratory Medicine today (July 12).

There is some recent evidence that using nasal sprays to clear the virus from the nose and throat or improving immune function by increasing exercise and managing stress could reduce the frequency and severity of respiratory infections. To investigate this, researchers undertook a large randomized trial to compare the effectiveness of two different types of nasal spray and an online resource providing advice on physical activity and stress management.

The researchers recruited 13,799 adult patients from 332 general practice practices. All patients had an existing health problem or a risk factor for infection and/or recurrent respiratory infections in the past. Patients were randomized to receive one of three interventions. These were: a Vicks-First-Defence gel-based nasal spray – which uses a microgel to trap viruses and neutralize viruses in the nose, helping to prevent the virus from developing and spreading; a saline nasal spray – which reduces virus levels in the nasopharynx; or an online resource that promotes physical activity and stress management.

All three interventions reduced antibiotic use (a relative risk reduction of more than 25 percent) and also the number of days with more severe symptoms. Even though participants did not use the sprays as often as required, both sprays were shown to reduce the overall duration of illness experienced by participants by approximately 20% and lead to a 20-30% reduction in days lost from work. or normal activity.

In comparison, online advice on behavioral physical activity and stress management reduced the incidence of infections by a modest relative reduction of five percent. However, this cost-effective option could have a significant population impact given how easy it is to provide online advice to the general public.

Paul Little, research professor of primary care at the University of Southampton, who led the study, said: “Our results show that nasal sprays work well to reduce the duration and severity of respiratory infections, as well as the interference with normal activities , which is particularly important. in light of the increase in winter infections that the UK regularly experiences. The important finding of a reduction in antibiotic use is also potentially very important in the fight against antibiotic resistance, one of the major public health threats of our time.

“Given these results, our advice, especially for those at higher risk of infections or those who get recurrent infections, is at the first sign of a cough, sore throat, cold or flu-like symptoms, use a nasal spray to prevent full development. and use the sprays prophylactically after close exposure to people with infections.”

Lucy Yardley, OBE, professor of health psychology at the Universities of Bristol and Southampton, who led the nasal spray part of the study, added: “Our analysis suggests that the benefits were even greater when people used the sprays more often – we advised six times a day at the first sign of a cold – but many people in the study did not use the spray as often .”

Dr Adam Geraghty, Associate Professor of Psychology and Behavioral Medicine at the University of Southampton, who led the exercise and stress reduction part and coordinated the study, explained: “If used widely, these interventions could have a valuable role in reducing the consumption of antibiotics. and antimicrobial resistance and in reducing the impact of respiratory viruses on patients, health services and the wider economy.”

The study was funded by NIHR Program Grants for Applied Research (RP-PG-0218-20005) with support from the NIHR Health Protection Research Unit (HPRU) in Behavioral Science and Evaluation and NIHR Applied Research Collaboration West (ARC West).

The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Paper

“A randomized, open-label, multi-arm trial of nasal sprays and a behavioral intervention for respiratory infections in primary care (The Immune Defense Study)” by Professor Paul Little et al. in the The Lancet Respiratory Medicine

Additional Information

A short version of the guidance given to study subjects is available at: https://immunedefence.lifeguide.site/

The Active Lives physical activity intervention offered to people taking part in this trial will be made available to NHS patients by healthcare provider ‘Living With’, see: https://livingwith.health/active-lives/