For patients who suffer from recurrent or persistent sinus infections as well as those wishing to diminish risk of a viral upper respiratory infections, medicated sinus rinses can be performed 1-2 times per day. Under the direction of a physician, such nasal rinses can be performed with betadine or ioRinse antiseptics which have both anti-bacterial as well as anti-viral properties or with prescription bactroban ointment which is effective against bacterial sinus infections. There are numerous other types of antibiotic sinus flushes available, but can only be obtained from compound pharmacies and are often not covered by insurance. Typically, those patients who have had prior sinus surgery benefit greatly from this intervention compared to those who have not.
What's the supporting research?
Published back in 2004, researchers noted that daily saline nasal spray (plain old saltwater) use appears to significantly prevent symptoms of the common cold (which includes coronaviruses) in a population of otherwise healthy adults [link]. Needless to say, one should avoid sharing the same saline nasal spray bottle.
There is also this research that determined 0.23% betadine (aka, providone iodine prep solution) rapidly kills both bacteria and viruses within 15 seconds (in vitro).
Based on all this data, some ENTs advocate that saline rinses twice a day would probably work better than saline nasal spray. Additionally, adding betadine into the saline mixture might confer additional benefit due to their virucidal effects. A meta-analysis also supported use of betadine in this fashion.
To make your own 1% betadine saline solution to use in the nose whether by spray or rinse, just add 2.4 ml of 10% betadine to 8 ounces (240ml) of saline. Just be aware of a mild temporary nasty aftertaste after using.
A daily nasal spray with saline prevents symptoms of rhinitis. Acta Otolaryngol. 2004 Nov;124(9):1059-62.
In Vitro Bactericidal and Virucidal Efficacy of Povidone-Iodine Gargle/Mouthwash Against Respiratory and Oral Tract Pathogens. Infect Dis Ther. 2018 Jun; 7(2): 249–259.
Consideration of povidone-iodine as a public health intervention for COVID-19: Utilization as “Personal Protective Equipment” for frontline providers exposed in high-risk head and neck and skull base oncology care. Oral Oncol. 2020 Apr 16 : 104724.
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