Impact of gargling on respiratory infections

Figures & data

Table 1. Mechanism of action, antimicrobial, and antiviral activity of mouthwashes from synthetic origin.

Mouth wash type	Mechanism	Activity against microbes and viruses
Povidone Iodine	Effectiveness is due to the conversion of iodide to molecular iodine (I2) and hypoiodous acid (HOI). The two forms of iodine disrupt the cell walls of microbes by inducing pore formation causing loss of cytosol and enzyme denaturation (Eggers 2019).	Gram-positive bacteria, Gram-negative bacteria, mycobacteria, fungi, chlamydiae, viruses, and protozoans (Schreier et al. 1997).
Chlorhexidine	Low concentrations: bacteriostatic and cell irreversibly damaged. Higher concentrations: bactericidal by causing the precipitation of cytoplasm (Basrani 2005).	Gram-positive and Gram-negative bacteria. Facultative anaerobic and aerobic bacteria, spores, viruses, and yeast (Basrani 2005).
Benzydamine	Synergize the effect of antibiotics. Increases bacterial uptake of tetracyclines and chloramphenicol (Quane et al. 1998)	Nonspecific antibacterial activity (Quane et al. 1998)
Cetylpyridinium Chloride	The positively charged cetylpyridinium chloride is attracted by the negative surface of the bacteria and adsorption on the cell causes the death of bacterial cells (Franklin et al. 2014)	Candida albicans (Fu et al. 2014), Actinomyces, Campyaobacter, Moraxella, Veillonella, Eikenella corrodens, Porphyromonas gingivalis, Prevotella intermedia, and Prevotella nigrescens (Sreenivasan et al. 2013)
C31 G	The alkyl portion of C31 G disrupts the microbial membrane (Corner et al. 1988).	Gram-positive bacteria, gram-negative bacteria and Candida albicans, yeast (Corner et al. 1988), Influenza A and influenza B virus (Lee et al. 2014)

Table 2. Mechanism of action, antimicrobial, and antiviral activity of mouthwashes from natural origin.

Mouth wash type	Mechanism	Activity against microbes and viruses
Sodium chloride	Intracellular hypochlorous acid (HOCl) has antibacterial and antiviral activity. By increasing the availability of sodium chloride (hypertonic solution) in non-myeloid cells can enhance the formation of HOCl.	A broad range of bacteria and viruses (Block and Rowan 2020). Herpes simplex virus-1, murine gammaherpesvirus 68, respiratory syncytial virus, influenza A virus, human coronavirus 229E, coxsackievirus B3 (Ramalingam et al. 2018).
Green tea	Green tea extracts inhibit influenza infectivity by preventing the entry of the virus into the cells. Inhibits virus growth by preventing acid-catalyzed fusion reaction and thus inhibits the growth of influenza A and B (Imanishi et al. 2002). Antibacterial activity by (i) cell wall and cell membrane disruption; (ii) inhibition of intracellular enzymes; (iii) oxidative stress; (iv) DNA damage; and (v) iron chelation (Renzetti et al. 2020)	Antibacterial (methicillin-resistant Staphylococcus aureus or Stenotrophomonas maltophilia, Aggregatibacter actinomycetmcomitans, Vibrio cholera, Lysteria monocytogenes, Pseudomonas aeruginosa, Escherichia coli, Clostridium perfringens, Bacillus subtilis, Staphylococcus epidermidis, Acinetobacter baumannii, Stenotrophomonas maltophilia, Pseudomonas fluorescens, Mycobacterium tuberculosis, Actinomyces, Bordetella bronchiseptica, Serratia marcescens, Salmonella enteritidis, Proteus mirabilis), antifungal (Candida albicans), antiviral (influenza virus) (Renzetti et al. 2020; Steinmann et al. 2013)
Essential oils	The proposed antibacterial mechanism of essential oils is the disruption of the cell wall of bacteria and inhibition of bacterial enzymes. It is also assumed that the essential oils extract the polysaccharide-derived endotoxin from gram-negative bacteria (Mandel 1994).	Herpes simplex type-1 and type-2 and influenza A, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus vulgaris, Bacillus subtilis, Staphylococcus aureus Streptococcus mutans, Enterococcus faecalis,Eikenella corrodens and Candida albicans (Dennison et al. 1995) (Prabuseenivasan et al. 2006; Serra et al. 2018; Vlachojannis et al. 2015)
Licorice	Wang, Yang et al., has described the antibacterial, antifungal, and antiviral mechanisms and activities in detail (Wang et al. 2015).	Human respiratory syncytial virus, Herpes simplex virus, Methicillin-resistant Staphylococcus aureus, Methicillin-sensitive Staphylococcus aureus (Wang et al. 2015), influenza A virus (Wolkerstorfer et al. 2009),Streptococcus pyogenes, Haemophilus irnfluenzae and Moraxella catarrhalis (Tanaka et al. 2001)
Eucalyptol	(Eucalyptol) 1,8- cineole suppresses mucus hypersecretion caused by rhinosinusitis and bacteria (Cai et al. 2020).	Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli and Candida albicans, and biofilm cultures of MRSA and Pseudomonas aeruginosa. (it is more effective when used in combination with other essential oils and antiseptics) (Hendry et al. 2009)
Lactoferrin	Lactoferrin act as a bactericidal by interacting with (i) lipopolysaccharide of gram-negative bacteria or (ii) by the interaction of lipoteichoic acid of gram-positive bacteria. Lactoferrin has virucidal activity by blocking cellular receptors or by direct binding to the virus (Berlutti et al. 2011)	E. coli, Staphylococcus aureus, Pseudomonas aeruginosa, Helicobacter pylori, Bacillus subtilis, Vibrio cholerae, and Candida albicans. Cytomegalovirus, HIV, Herpes virus, Hepatitis B and C, Hantavirus, Human papillomavirus, Rotavirus, Adenovirus, and Influenza A (Hill and Newburg 2015)

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Data availability statement

It is a review article and the data availability statement is not applicable.