Xylitol Nasal Spray Prevents SARS-CoV-2 Infection

The sophisticated American consumer has grown accustomed to the gold-standard for drug and health products—the prospective Randomized, double-blind, placebo-Controlled Trial (RCT). Operation Warp Speed (OWS) was supposed to be a churning mill of large RCT’s to help the nation understand what conclusively is effective in the prevention and treatment of COVID-19. Unfortunately, after three years, has delivered failed products (remdesivir, baricitinib, molnupiravir, COVID-19 vaccines) and small inconclusive trials of products that doctors have found effective in practice including off-target generic antivirals and anticoagulants. OWS did not test simple, affordable, available prevention strategies. Fortunately such RCTs where done outside of the US and have brought us important findings.

Balmforth et al, conducted a prospective double-blind, placebo-controlled trial of a xylitol based nasal spray in the prevention of SARS-CoV-2 infection in exposed healthcare workers in two hospitals in Uttar Pradesh, India. Xylitol is known to have anti-infective and anti-inflammatory properties and is used in XLEAR nasal spray and anti-infective chewing gum to prevent dental caries. Balmforth found that SARS-CoV-2 infection confirmed by serology was 71% lower with xylitol compared to placebo [36 cases (13.1%) Vs 97 cases (34.5%); odds ratio [OR] 0.29 (95% CI; 0.18–0.45), p < 0.0001]. Fewer clinical symptoms were also seen in the test group [57 cases (17.6%) vs 112 cases (34.6%); OR 0.40, (95% CI; 0.27–0.59), p < 0.0001]. No harmful effects were associated with xylitol. 

A smaller study of xylitol nasal spray in mild COVID-19 cases demonstrated that persistent loss of smell may be eliminated with xylitol nasal spray during the acute congestion phase.



Balmforth D, Swales JA, Silpa L, Dunton A, Davies KE, Davies SG, Kamath A, Gupta J, Gupta S, Masood MA, McKnight Á, Rees D, Russell AJ, Jaggi M, Uppal R. Evaluating the efficacy and safety of a novel prophylactic nasal spray in the prevention of SARS-CoV-2 infection: A multi-centre, double blind, placebo-controlled, randomised trial. J Clin Virol. 2022 Oct;155:105248. doi: 10.1016/j.jcv.2022.105248. Epub 2022 Jul 25. PMID: 35952426; PMCID: PMC9313533.

I have been impressed with the RCTs of topical nasal sprays and gargles in COVID-19 far more than those with oral or intravenous drugs. Xylitol available as XLEAR in US pharmacies is one of several choices for local nasopharyngeal protection and treatment of COVID-19.

Sources and References:

Reposted from Peter A. McCullough’s Substack.

Related: Best Nasal Sprays for COVID-19

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