Even though much inhaled COVID-19 virus immediately penetrates into the lungs, some remains in the throat where it replicates to very high numbers–for instance, a peak at 711,000,000 RNA copies per throat swab day 4 (Wölfel R et al.  Nature 2020;Apr 1).  Many of these replicates presumably descend into the lungs, where they furnish a stream of reinforcements that may cumulatively outweigh the replication of the initial penetrating dose.  Hence treating the throat with gargling seems highly desirable. Continue reading »

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Slipping endlessly through the crack between oral and respiratory medicine, the humble mouthwash has slowly won more respect among savvy practitioners and patients as a solution for a range of indications. In Japan many millions of people gargle three times a day with povidone-iodine or other mouthwashes to ward off upper respiratory tract infections (URTIs), and Japanese clinical studies have confirmed the value of this approach (a recent study is Furushima D et al. Molecules. 2018 Jul 20;23(7)). Worldwide, medical practitioners recommend gargling to patients; and many people on their own have decided that gargling makes sense, while millions swish with mouthwash to protect teeth and gums as well as to combat halitosis.

Still, for curious reasons, this formidable method of suppressing infections remains in medical limbo. Not because there is no need. The average American suffers 2.5 episodes of URTI per year, with high costs for treatment, lost days of work, and morbidity. URTIs also exacerbate asthma, and they can enter the lungs and prove fatal. Continue reading »

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