Options for local therapy of chronic tonsillopharyngitis to achieve a long-term remission

Abstract

Topicality: Chronic tonsillopharyngitis is one of the most common diseases of the upper respiratory tract. Although more and more physicians are preferring modern non-surgical treatments and abandoning the use of surgery to treat chronic compensated tonsillopharyngitis, there is still no consensus on approaches to conservative therapy. One of the modern methods of controlling the microflora of the oral cavity is the use of lantibiotics. This creates competitive pressure of endogenous opportunistic flora and viruses, preventing episodes of disease recurrence. The relevance of our study is due to the need to optimize and improve pharmacotherapy, not only during the exacerbation of the disease, but also to form a stable remission, which will significantly improve the quality of life of patients. Materials and methods: A total of 36 patients were observed in the study, who were divided into two groups with different treatments. Group 1 received classical therapy, including local sanitation of the tonsils by was hing the gaps with NaCl solution 0.9% daily from the first visit until the 7th day and taking topical combination drugs (antiseptic, local nonsteroidal anti-inflammatory drug – benzydamine) for 1 tab. 3 times a day for 7 days. Group 2, if necessary, received washing the lacunae of the tonsils with a solution of 0.9% NaCl, and took an oral probiotic Baсtoblis (S. salivarius K12) 1 tab. at night for 1 month according to the instructions. The McIsaac scale and microbiological examination of pharyngeal smears were used to establish the clinical diagnosis. Results: On the seventh day of treatment, there is a rapid improvement in the well being of patients in both groups. In the first group there is a more effective elimination of pain symptoms and in the second group of bad breath. However, at the time of the 16th week from the start of treatment, in the first group due to more frequent recurrences of the disease, there is a significant deterioration in all indicators. The results of the microbiological study revealed a significant reduction in the colonization of the oropharyngeal cavity by pathogenic strains of staphylococci and Escherichia coli in group 2 at 16 weeks after treatment. Conclusion: Based of the study, it can be concluded tht bacterial therapy has shown significant effectiveness in achieving long-term remission in contrast to the other study group, which was effective only during the acute period of the disease.