The role of OM-85 BV (Broncho-Vaxom) in preventing recurrent acute tonsillitis in children

Abstract

ObjectiveTo evaluate the efficacy of an immunostimulant (bacterial lysate) Broncho-Vaxom in the management of children with recurrent acute tonsillitis. MethodsA 5-year retrospective cohort study of 177 children presenting with a diagnosis of recurrent acute tonsillitis. Patients’ demographics and laboratory studies at presentation were retrieved. For patients given Broncho-Vaxom, we defined response as a decrease in the frequency of acute tonsillitis episodes after 3 months of therapy (partial: by ≤50% and total: by >50%). Patients showing response to Broncho-Vaxom were further followed until study-end or need for tonsillectomy. ResultsThe median age of patients was 4.5 years (range: 1–15 years) with 63.8% being males. 131 (74%) patients received Broncho-Vaxom as initial therapy, and 99 (75.6%) showed response (51.2% total and 24.4% partial response). A normal ESR level was the only predictor of total compared with no response (OR: 3.53, 95% CI: 1.03–12.07); while both normal ESR (OR: 7.15-times, 95% CI: 1.18–43.39) and normal CRP (OR: 12.66, 95% CI: 1.43–111.86) levels were independent predictors of total over partial response. None of the patients showing total response required tonsillectomy on long-term follow up while in those with partial response 34.4% required subsequent tonsillectomy (median follow-up: 9 months). ConclusionsA considerable proportion of children receiving Broncho-Vaxom for recurrent acute tonsillitis show a decrease in the frequency of episodes in the short term, and very few patients eventually require tonsillectomy on long-term follow up.