OTC Nasal Sprays May Help Cut Antibiotic Use for Upper Respiratory Infections

New research suggests over-the-counter (OTC) nasal sprays may help reduce the overuse of antibiotics for upper respiratory infections.

The study, published in Lancet Respiratory Medicine, analyzed data from nearly 14,000 adults. It found that common OTC nasal sprays, such as saline and gel-based spray, reduced the number of sick days by about 20%—from eight days to six and a half. As a result, the patients were less likely to ask for antibiotics.

For the study, the researchers divided participants at risk for respiratory infections into one of three groups. One group used Vicks First Defence gel-based nasal spray, which traps and neutralizes viruses in the nose. The second group used a saline nasal spray designed to help reduce viral levels behind the nose. The third group was given an online resource that encouraged physical activity and promoted stress management.

While all of the groups cut antibiotic use by about 26% to 35%, those who used nasal sprays recovered faster than the stress management group. Researchers also found that people in the spray groups experienced a 20% reduction in lost workdays due to illness, compared to about 1% in the stress management group.

This study focused on people who are more likely to experience complications from infections. Due to their health history, they “commonly still get antibiotics for most uncomplicated respiratory infections,” said lead study author Paul Little, MBBS, professor of Primary Care Research at the University of Southampton in the United Kingdom.

“We hypothesized that if people had something that worked for managing their illnesses their symptoms, they would be less likely to ask for and use antibiotics,” Little said.

Antibiotic alternatives can help improve people’s symptoms while saving them money, but also lower the risk of antibiotic resistance and other health issues that can arise from overuse, according to Michael Yong, MD, an otolaryngologist and neurorhinologist at Pacific Neuroscience Institute in Santa Monica, CA.

“[Most] upper respiratory tract infections are viral in nature,” Yong said. “They don’t need an antibiotic to take care of it.”

Will Nasal Sprays Become the Standard Treatment for Upper Respiratory Infections?

Currently, there’s no official guideline that recommends using a nasal spray to speed up healing from an upper respiratory infection.

“I don’t think we are there yet. This study needs to be repeated,” said Alfred F. Tallia, MD, MPH, professor and chair of family medicine and community health at the Rutgers Robert Wood Johnson Medical School.

Although there’s no official recommendation, there’s a “relative lack of harm” in using nasal sprays, Tallia added.

It’s a good idea to start with a saline spray when you’re sick, which many doctors recommend anyway, Stokes Peebles, MD, a professor of medicine at Vanderbilt University Medical Center, told Verywell. “It will be cheaper, and there are no potential side effects.”

However, Peebles said he’s “not overwhelmed” with the new study’s findings. “The difference between six and a half and eight days of an illness, when symptoms already tend to be more mild, is not much,” he added.

Barbara Bawer, MD, a family medicine physician at The Ohio State University Wexner Medical Center, told Verywell that more studies are needed, “especially to understand risk reduction with consistent use of the spray, since this study did mention most people did not use it six times per day as asked.”

When to See a Doctor for an Upper Respiratory Infection

While using a nasal spray may speed up healing when you have an upper respiratory infection, there are clear signs of when you should seek medical care.

“If your symptoms are not getting better and you have persistent fever, or you have underlying conditions like asthma or immunosuppression, it’s a good idea to seek a professional assessment,” Tallia said.

Little said that it’s “never very clear-cut” when people may need antibiotics, but recommends calling a doctor if you symptoms are getting worse or have lasted 10 or more days.