In this episode, Julia Rawlinson speaks with Professor Paul Little, is a Professor of Primary Care Research at the University of Southampton and a practising GP with over 20 years of clinical experience, about his landmark research on acute respiratory tract infections and its relevance for general practice.

Professor Little summarises the Lancet Respiratory Medicine trial involving nearly 14,000 participants at risk of respiratory infections. The trial compared usual care, two nasal sprays (Vicks First Defense and isotonic saline), and a digital lifestyle intervention. Both nasal sprays resulted in fewer days ill, reduced antibiotic use by around 30%, and were well tolerated. The saline spray was highlighted as a first-choice option due to its effectiveness and minimal side effects.

Giving practical advice on counselling patients to use nasal sprays at the first sign of illness, with discussion around challenges to adherence and the rationale for early use. They also explore the antiviral mechanism of saline spray and the continued value of stress management and physical activity in infection prevention.

Professor Little discusses how setting realistic expectations about infection duration can help reduce unnecessary presentations and prescribing, and how these simple interventions contribute to antibiotic stewardship in primary care.

Links & Resources:

• https://www.southampton.ac.uk/people/5wzg2s/professor-paul-little#publications
• 12 month follow-up of a randomised open label trial of nasal sprays and a behavioural intervention for respiratory tract infections (RTIs) in primary care: https://eprints.soton.ac.uk/507356/

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