A Clinical Trial of Hypertonic Saline Nasal Spray in Subjects With the Common Cold or Rhinosinusitis

Adam, Patricia MD, MSPH; Riverside University Family Practice Clinic
Stiffman, Michael MD, MSPH; St Paul Family Medicine Residency Program
Blake, Robert L. Jr, MD; Dept. of Family Practice and Community Health, Uni.of Minnesota and Dept. of Family and Community Medicine, Uni. of Missouri-Columbia

Abstract

Objective: To determine whether Hypertonic saline nasal spray relieves nasal symptoms and shortens illness duration in patients with the common cold or acute rhinosinusitis.
Design: Randomized trial with 2 control groups.
Setting: Two family practice clinics.
Participants: One hundred forty-three adult patients with a cold or sinus infection. Patients with allergic rhinitis, symptoms for more than 3 weeks, or other respiratory diagnoses were excluded, as were those who had used topical decongestants.
Intervention: Hypertonic saline or normal saline spray 3 times a day or observation. Subjects completed a 7-day symptom checklist that included a well-being question ("Do you feel back to normal?").
Main Outcome Measures: Nasal symptom score (sum of scores for nasal congestion,rhinorrhea, and headache) on day 3 and day of well-being (day of symptom resolution).
Results: Data were collected for 119 subjects. No difference was found in either primary outcome when Hypertonic saline was compared with either normal saline or observation. Mean day of well-being was 8.3 (95% confidence interval [CI], 6.9-9.7), 9.2 (95% CI, 6.9-11.43), and 8.0 (95% CI, 6.7-9.3) days in the Hypertonic saline, normal saline, and observation groups, respectively. Day 3 mean nasal symptom score was 3.8 (95% CI, 3.0-4.5) for Hypertonic saline, 3.7 (95% CI, 2.9-4.5) for normal saline, and 4.1 (95% CI, 3.5-4.7) for observation. Only 44% of the patients would use the Hypertonic saline spray again. Thirty-two percent noted burning, compared with 13% of the normal saline group (P=.05).
Conclusion: Hypertonic saline sprays do not improve nasal symptoms or illness duration in patients with the common cold or rhinosinusitis.

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