Saline nasal wash significantly improved symptoms in children with acute common colds or respiratory flu, and also reduced recurrences, researchers reported.
An isotonic saline nasal wash made from processed seawater thinned and reduced nasal secretions as well as relieved nasal obstruction and sore throat in a study of 401 patients aged 6–10 years. Treated children showed significantly less use of cold medications than did controls, had fewer school absences, and had fewer complications such as otitis media and sinusitis.
The treated children also showed greater improvement in overall health status and fewer recurrences of upper respiratory tract infection when they continued using the nasal spray as a preventive after the acute illness had resolved, according to Dr. Ivo Slapak of Teaching Hospital Brno (Czech Republic).
The study was funded by Laboratoires Goëmar, Saint-Malo (France), which supplied the nasal wash. The manufacturing process of this commercially available product “preserves the concentrations of ions and trace elements to levels comparable with those of seawater,” Dr. Slapak and his associates said.
Saline has anti-inflammatory activity, but the product's mechanism of action is not known. “It is not clear whether the effect is predominantly mechanical, based on clearing mucus, or whether salts and trace elements in seawater solutions play a significant role,” they added.
Several guidelines mention the potential benefit of saline nasal wash in treating colds and flu, although “evidence of its efficacy is rather poor,” the investigators noted. A large study in adults showed that the treatment had no effect.
In what they described as the first prospective study to assess the adjunctive treatment in children, Dr. Slapak and his associates at eight pediatric outpatient clinics randomly assigned patients to receive standard treatment either alone (101 subjects) or with open-label adjunctive nasal wash at one of three strengths: medium jet flow (100 subjects), fine spray (100 patients), or a dual eye-and-nose formula with a fine spray (100 subjects).
The saline wash was administered six times per day during the acute illness and three times per day during the prevention phase of the study. Standard treatment included antipyretics, decongestants, mucolytics, and systemic antibiotics, all given at the treating physician's discretion.
All the patients were followed for 12 weeks during cold season, from the onset of their acute illness until spring.
Acute nasal symptoms cleared more quickly in the children who received the nasal wash at any strength, and those subjects also used significantly fewer medications both acutely and during follow-up. Unblinded physicians and parents both rated the children's health status as significantly better in the treatment groups than in the control group. (See box.)
“Results were robust, consistent, and statistically significant, in contrast to the few published articles that do not clearly show the benefits of nasal wash to treat the common cold,” the investigators said (Arch. Otolaryngol. Head Neck Surg. 2008;134:67–74).
Significantly fewer subjects who used long-term nasal wash reported days of illness, absences from school, or complications. (See box.)
The researchers disclosed that they had received speakers' honoraria from various pharmaceutical firms, and some have worked or will work on projects for commercial drug laboratories.
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