Simple Interventions Reduce Respiratory Infection Days, Antibiotic Use

Compared with usual care, advice to use nasal spray at the first sign of a respiratory tract infection reduced the duration of respiratory infections, while nasal spray and a behavioral intervention promoting physical activity and stress reduction reduced antibiotic use. Researchers published their findings in The Lancet Behavioral Medicine.

“If widely advocated, these simple, scalable interventions could potentially have an important role in antimicrobial stewardship and in reducing the impact of respiratory viruses,” wrote corresponding author Paul Little, FMedSci, of the University of Southampton Primary Care Research Centre in Southampton, England, and study coauthors.

The study randomly assigned patients at increased risk from, or prone to, respiratory illness at 332 general practitioner practices to one of several interventions: brief advice about managing illness, which was categorized as “usual care”; gel-based nasal spray at the first sign of or potential exposure to an infection; saline nasal spray at the first sign of or potential exposure to an infection; or a brief behavioral intervention in which participants were directed to a website promoting physical activity and stress management. Patient surveys at 6 months provided outcome data.

Among 11 612 patients, 2983 were in the usual care group, 2935 were in the gel-based nasal spray group, 2967 were in the saline nasal spray group, and 2727 were in the behavioral website group.

Compared with an average 8.2 days of respiratory illness over 6 months in the usual care group, average days of illness were 6.5 days for the gel-based nasal spray group, 6.4 days for the saline nasal spray group, and 7.4 days for the behavioral website group, according to the study. Although the behavioral website group did not differ significantly from the usual care in days of illness, all three interventions were associated with lower antibiotic use compared with usual care. Reported incidence rate ratios for antibiotic use were 0.65 for the gel-based nasal spray group, 0.69 for the saline nasal spray group, and 0.74 for the behavioral website group compared with the usual care group.

“Future research should aim to address the impact of the widespread implementation of these simple interventions,” researchers wrote.

Reference

Little P, Vennik J, Rumsby K, et al. Nasal sprays and behavioural interventions compared with usual care for acute respiratory illness in primary care: a randomised, controlled, open-label, parallel-group trial. Lancet Respir Med. 2024;12(8):619-632. doi:10.1016/S2213-2600(24)00140-1