title: Antiseptic mouthwash against pharyngealNeisseria gonorrhoeae: a randomised controlled trial and an in vitro study.
abstract: Gonorrhoea is increasing among men who have sex with men (MSM). We aimed to determine whether Listerine, a commercial mouthwash product, has an inhibitory effect againstNeisseria gonorrhoeaein a randomised controlled trial (RCT) and an in vitro study, and therefore may be a potentially useful agent for gonorrhoea control.
  
  
  
  In vitro: a suspension of ∼108colony forming units per mL (CFU/mL) ofN. gonorrhoeaewas added to a serial of dilutions (up to 1:32) of alcohol-containing Listerine mouthwashes (Cool Mint and Total Care) for 1 min. A 10 µL aliquot was spread over the surface of a gonococcal agar plate and the number ofN. gonorrhoeaecolonies present at each dilution was calculated. The phosphate buffered saline (PBS) was used as a control. RCT: we recruited MSM with pharyngeal gonorrhoea who returned for treatment at the Melbourne Sexual Health Centre between May 2015 and February 2016. Untreated men were randomised to rinse and gargle either Listerine Cool Mint or saline for 1 min. Pharyngeal swabs were taken before and after rinsing and gargling for culture ofN. gonorrhoeae. The analysis included only men who were culture positive forN. gonorrhoeaebefore using the allocated solution on the day of recruitment.
  
  
  
  In vitro: Listerine mouthwashes at dilutions of up to 1:4 for 1 min resulted in significant reduction of totalN. gonorrhoeaecounts but PBS has no inhibitory effect againstN. gonorrhoeae. RCT: a total of 196 MSM were recruited, 58 (30%) were culture positive before using the solution. After gargling the allocated solution, men in the Listerine group were significantly less likely to be culture positive on the pharyngeal surface (52%) compared with men in the saline group (84%) (p=0.013).
  
  
  
  This data suggest Listerine, significantly reduces the amount ofN. gonorrhoeaeon the pharyngeal surface. With daily use it may increase gonococcal clearance and have important implications for prevention strategies.
  
  
  
  ACTRN12615000716561.
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.|Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Eric Pf
authors.initials: EP
authors.lastname: Chow
authors.affiliation: Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Howden
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.|Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Walker
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Lee
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.|Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Catriona S
authors.initials: CS
authors.lastname: Bradshaw
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.|Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Marcus Y
authors.initials: MY
authors.lastname: Chen
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Snow
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
authors.forename: Stuart
authors.initials: S
authors.lastname: Cook
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
authors.forename: Glenda
authors.initials: G
authors.lastname: Fehler
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.|Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000494:pharmacology / Q000627:therapeutic use*; D001315:Australia; D006069:Gonorrhea / Q000382:microbiology* / Q000517:prevention & control*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D009067:Mouthwashes / Q000494:pharmacology / Q000627:therapeutic use*; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000235:genetics; D021141:Nucleic Acid Amplification Techniques; D010608:Pharyngeal Diseases / Q000382:microbiology / Q000517:prevention & control*; D010614:Pharynx / Q000382:microbiology*; D010865:Pilot Projects
chemical_list: D000891:Anti-Infective Agents, Local; D009067:Mouthwashes
keywords: CLINICAL TRIALS; GAY MEN; GONORRHOEA; INTERVENTION STUDIES; NEISSERIA GONORRHOEA