Abstract
PurposeAcute pharyngitis is an uncomfortable disorder mostly caused by viruses and for which antibiotics are unwarranted. This study compared lozenges containing ectoine, a natural extremolyte, with hyaluronic acid lozenges and hypertonic saline gargle for symptomatic treatment of acute viral pharyngitis.MethodsThis prospective, controlled clinical study, recruited 90 patients with moderate-to-severe pharyngitis symptoms who chose to use either ectoine (n = 35), hyaluronic acid (n = 35), or saline gargle (n = 20). Patients applied their 7-day treatment from the inclusion visit (V1) until the end-of-study visit (V2). Patients’ pharyngitis symptoms, general health, general treatment effectiveness and tolerability, and patient compliance were assessed by investigators and patients.ResultsThe sum score for three primary symptoms (pain on swallowing, urge to cough, and hoarseness) decreased by 79.5% (ectoine), 72.2% (hyaluronic acid), and 44.8% (saline gargle). Both lozenges were significantly superior to saline gargle (P < 0.05). Regarding general health improvement, ectoine was significantly superior to saline gargle (72.5% vs. 45.2%, P < 0.05), but hyaluronic acid (63.3%) was not. At V2, 65.7% of patients receiving ectoine reported “very good” general health vs. 48.6% of those receiving hyaluronic acid and 20.0% using saline gargle. Ectoine was significantly superior (P < 0.05) to both hyaluronic acid and saline gargle in terms of tolerability and patient compliance. No patients taking ectoine reported unpleasant sensations while applying their treatment, whereas almost half of patients using hyaluronic acid lozenges and saline gargle did.ConclusionTreatment with ectoine lozenges significantly relieves moderate-to-severe symptoms of acute viral pharyngitis and is more effective and tolerable than treatments with hyaluronic acid lozenges and hypertonic saline gargle.
Highlights
Acute pharyngitis is a highly prevalent community-acquired infection characterised by a sore throat
In our previous work [28], we demonstrated the superiority of a mouth and throat spray containing ectoine over saline lozenges in the treatment of mild-to-moderate acute pharyngitis and/or laryngitis
There were more female than male patients in all groups; the distribution of female and male patients was similar across all groups
Summary
Acute pharyngitis is a highly prevalent community-acquired infection characterised by a sore throat. This disorder is mostly caused by viruses (i.e., uncomplicated, self-limited acute pharyngitis), is generally treated symptomatically [1], and, does not require antibiotics. The only common type of acute pharyngitis that calls for antibiotics involves group A Streptococcus [2], representing about 10% of all cases in adults [3]. Despite decades of efforts to reduce the rate of antibiotic prescription for acute pharyngitis, it is currently about 60% [4, 5], far exceeding what is clinically justified. Antibiotics improve symptoms and duration of disease modestly [7], and the risk of developing complications
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