Treatment Of Acute Tonsillopharyngitis Research Articles

Modern aspects of treatment of acute tonsillopharyngitis

Introduction. Primary referral for infectious and inflammatory diseases of the pharynx reaches 30%.Aim. To study the effectiveness of ambazon in patients with acute tonsillopharyngitis.Materials and methods. The study was conducted at the SCDC Clinics of the Samara State Medical University and the CDC “Persona-Med” LLC in 75 patients (45.9 ± 11.2 years old) with acute tonsillopharyngitis (ATP). The main group (Group I, n = 48) additionally received ambazon, 1 tablet for resorption 15 minutes after meals 4 times a day for 4 days. The control group (Group II, n = 27) received symptomatic therapy. On the 1st, 2nd and 4th day, the complaint of sore throat was assessed using a visual analogue scale (VAS), the frequency of additional complaints, and the pharyngoscopic picture using a 4-point scale.Results and discussion. On the 2nd day, the severity of sore throat according to VAS in group I was 3.5 ± 0.2 points, in group II 4.9 ± 0.3 points (p < 0.05). On the 4th day, the severity of sore throat in group I had lower values 1.1 ± 0.1 points, in group II 2.9 ± 0.1 points (p < 0.05). On the 2nd day, complaints of a sensation of a foreign body in the oropharynx and discomfort when swallowing in group I amounted to 27.1% and 45.8%, and in group II 77.8% and 66.7%, respectively. The pharyngoscopic picture in group I was characterized by a decrease in the severity of edema and hyperemia of the pharyngeal mucosa (score of 1.3 ± 0.3 points and 1.1 ± 0.2 points), in group II 2.1 ± 0.3 points and 2.9 ± 0.4 points, respectively. On the 4th day, the pharyngoscopic picture in group I returned to normal, while in group II, hyperemia and edema of the mucosa and an increase in regional lymph nodes persisted.Conclusions. The use of ambazon in the treatment of ATP allows to reduce the severity of the pain symptom, reduce the frequency of additional complaints and normalize the pharyngoscopic picture.

Раціональний підхід до лікування гострих тонзилофарингітів у дітей

У роботі розглянуто варіант місцевої протизапальної терапії при гострому тонзилофарингіті в дітей із протизапальним, анальгетичним, антимікробним і противірусним ефектом як у вигляді монотерапії, так і в комплексі з антибактеріальними засобами.

Современные тенденции в лечении острых тонзиллофарингитов у детей

Sore throat is one of the most common reasons for going to a primary care doctor and at the same time self-medicating with antibiotics. The main task of a pediatrician at an outpatient appointment is first of all to understand how to help a child (that is, to reduce pain) in order to improve his quality of life. Determining the streptococcal nature of the disease for the appointment of antibacterial therapy is a matter of prescribing systemic antibacterial therapy. In the treatment of acute tonsillopharyngitis, it is relevant to use safe and effective means as part of complex therapy to shorten the duration of the disease, reduce the risk of complications, prevent relapses and improve the quality of life. The integration of homeopathic medicines into complex treatment regimens makes it possible to increase their effectiveness and reduce the drug load. The use of homeopathy in the Russian Federation is permitted and regulated by law. Of the complex homeopathic preparations intended for the treatment of acute and chronic inflammatory diseases of the lymphopharyngeal ring, Tonsilotren is the most studied. The drug is organotropic, because its composition includes components that have maximum tropicity to the lymphoid tissue of the tonsils. Tonsilotren® is a highly effective and safe drug that can be used as part of the complex therapy of both acute tonsillopharyngitis and exacerbations of chronic tonsillitis. The drug has a pronounced positive effect on the relief of local signs of tonsillitis, as well as on improving the general condition of patients with pathology of the lymphopharyngeal ring, which has been proven both in experiment and in a series of clinical studies. Key words: tonsillar pathology, acute tonsillopharyngitis, targeted drugs

Comparative characteristics of the effectiveness of local therapy in acute tonsillopharyngitis

Acute tonsillopharyngitis (ATP) is an infectious inflammation of the mucous membrane and lymphadenoid structures of the oropharynx. Sore throat, as the main symptom of ATP, is the most common reason for seeking outpatient medical care or self-medication. Topical therapy of sore throat in the treatment of non-streptococcal ATP is the most effective and safe. In the article, based on their own experience and literature data, the problem of treating patients with sore throat with ATP of non-streptococcal etiology is presented. At the Department of Otorhinolaryngology of the Evdokimov Moscow State Medical University conducted a study to study the clinical features of the course of ATP and improve the results of local treatment of patients with this pathology. In the course of the study, 75 people were examined, in whom subjective and objective symptoms were assessed. Our study showed that the use of the drug Doritricin demonstrated high efficacy in the treatment of patients with ATP, which contributed to an earlier regression of inflammatory-infiltrative changes in the pharynx, as well as a faster decrease in the level of pain syndrome according to the scores of the visual-analog pain scale.

Применение пробиотического штамма Streptococcus salivarius К12 в лечении острых тонзиллофарингитов у детей

В статье освещено исследование эффективности применения штамма Streptococcus salivarius K12 в лечении острых тонзиллофарингитов у детей. Под наблюдением находилось 50 детей в возрасте от 2 до 17 лет с диагнозом острого стрептококкового тонзиллофарингита, из которых 25 составляли основную группу и получали в комплексном лечении Streptococcus salivarius K12 (препарат Бактоблис). Также в работе представлены результаты многочисленных исследований респираторного пробиотика, демонстрирующие его противомикробный потенциал и эффективность в лечении бактериальных инфекций ротоглотки.

Diagnosis and treatment of acute tonsillopharyngitis. Consensus document update

An update of the Spanish consensus document on the diagnosis and treatment of acute tonsillopharyngitis in 2011 is presented. Clinical scores should not be used to prescribe antibiotics, unless microbiological tests are not available or there is a child at risk of rheumatic fever. There is no score better than those set out in the previous consensus. Microbiological tests are recommended in proposed cases, regardless of the result of the scores. Penicillin is the treatment of choice, prescribed twice a day for 10 days. Amoxicillin is the first alternative, prescribed once or twice a day for the same time. First-generation cephalosporins are the treatment of choice in children with non-immediate reaction to penicillin or amoxicillin. Josamycin and midecamycin are the best options for children with immediate penicillin allergic reactions, when non-beta-lactam antibiotics should be used. In microbiological treatment failure, and in streptococcal carriers, the treatments proposed in the previous consensus are still applicable.

A modern approach to the diagnosis and treatment of acute tonsillopharyngitis in children

A modern approach to the diagnosis and treatment of acute tonsillopharyngitis in children

Comparative Study of the Efficacy of the Lysozyme, Benzydamine and Chlorhexidine Oral Spray in the Treatment of Acute Tonsillopharyngitis - Results of a Pilot Study.

Lysozyme is a natural antimicrobial and immunomodulatory enzyme, which is produced as a host response to infectious agents. The objective of this study was to compare the efficacy and safety of lysozyme-based versus benzydamine and chlorhexidinebased oral spray in patients with an acute tonsillopharyngitis associated with a common cold. A prospective twoarm pilot study (lysozyme/cetylpyridinium/lidocaine spray versus: benzydamine spray-arm 1; chlorhexidine/lidocaine spray-arm 2) was conducted in the primary health care unit. Efficacy was evaluated by the patient's self-assessment of pain, difficulty in swallowing and the throat swelling, by using the visual analog scale (VAS) at baseline and three follow-up visits. Safety was evaluated by the assessment of the frequency and severity of adverse effects. Lysozyme-based spray reduced pain faster than benzydamine-based spray and slower than chlorhexidine-based spray. Lysozyme-based and chlorhexidinebased sprays similarly reduced difficulty in swallowing, but were faster than benzydamine-based spray. Similar effects on the reduction of throat swelling were seen in all treated groups. All tested products showed proper safety and were well tolerated, with no serious adverse events reported. The lysozyme-based oral spray was shown to be effective and safe in the reduction of pain, difficulty in swallowing and throat swelling in patients with acute tonsillopharyngitis associated with a common cold. Lysozyme-based oral spray (containing natural compound with advantages of influencing immune system and preventing recurrences) had similar activity to benzydamine and chlorhexidine-based oral antiseptic sprays.

Optimization of clinical diagnosis and treatment of acute tonsillopharyngitis in children

Optimization of clinical diagnosis and treatment of acute tonsillopharyngitis in children

Efficacy of topical drugs in the treatment of patients with acute inflammatory diseases of the pharynx

The article discusses the main causative agents of acute inflammatory process of the pharynx, diagnostic features and treatment tactics. The question of the use of topical drugs in this pathology is covered. The data on the use of the drug Grammidin based on a local broad-spectrum antibiotic gramicidin C and antiseptic cetylpyridinium chloride, as well as data from clinical studies of the effectiveness of the drug in the treatment of acute tonsillopharyngitis in children and adults are presented.

The role of topical anti-inflammatory therapy in the management of acute tonsillopharyngitis in children

Acute tonsillopharyngitis (ATP) is the most common community-acquired infection, especially in children. Sore throat is the main manifestation of ATP. This is the most common reason for seeking outpatient medical care or self-medication. The widespread, unreasonable use of antibiotics for the therapy of sore throat, as the main component in the treatment of ATP without taking into account the presence of group A beta-hemolytic streptococcus, leads to an increase in the number of frequently ill children and dysbiosis of the mucous membranes. Topical therapy of sore throat is the most effective and safe approach to the management of ATP.

IMPORTANT FACTORS OF THE INFLAMMATORY PROCESS IN THE O ROPHARYNX AND OPTIMAL TREATMENT REGIMES SELECTION

Acute inflammatory diseases of the oropharynx dominate the medical aid appealability among all age categories. Such diseases are characterized by poly-ethiology and may form a mixed infection with bacteria and respiratory viruses. Components of bacterial cell walls, toxins, decay products of tissues during cytolysis or apoptosis of cells as a result of massive output of mature virions induce epithelial cells and macrophages for active synthesis of chemokines MCP-1, MCP-3, RANTES, IL-8, which leads to increased inflow of polymorphonuclear leukocytesin to the flammatory focus and a mass release of biogenic amines, lysosomal enzymes, cationic proteins, the release of arachidonic acid, which gradually turns into eicosanoids. Systemic use of NSAIDs can cause NSAID-associated gastropathies. Good accessibility of the target organ in diseases of the oropharynx allows target organspecific delivery of local treatment. Benzidamine hydrochloride (Tantum® Verde) refers to the group of anti-inflammatory suppressor of cytokines and also has a pronounced analgesic effect. The article provides data of the follow-up study of the efficacy of Tantum Verde® in the treatment of acute tonsillopharyngitis in outpatient settings.

Clinical Efficacy and Safety of Liquid Pelargonium sidoides Preparation (EPs 7630) in Children with Acute Non-Streptococcal Tonsillopharyngitis

Background: Acute tonsillopharyngitis is amongst the most common reasons for children, adolescents and young adults to consult with a physician. Despite extensive prescription, antibiotic therapy is indicated in less than one-fifth of these cases. New treatment strategies for patients with non-group-A-streptococcal acute tonsillopharyngitis are therefore required. Objectives: EPs 7630 is an extract from the roots of Pelargonium sidoides DC. After positive clinical study results in children with acute bronchitis, the present study was conducted to demonstrate the efficacy of EPs 7630 in the treatment of acute tonsillopharyngitis in children. Methods: In this double-blind placebo-controlled clinical trial with a group sequential design, the efficacy and tolerability of EPs 7630 were investigated in 6- to 10-year-old patients with acute tonsillopharyngitis, who showed no evidence of group A β-hemolytic streptococcus. Treatment duration was 6 days. Primary efficacy variable was change in the sum score of the tonsillitis severity score (TSS) on day 4 compared to baseline. Results: Overall, data on the change of the TSS measured for the EPs 7630 and placebo group were available for 60 and 64 children, respectively. After 4 days of treatment, the TSS had decreased from 9.6 ± 1.2 to 2.8 ± 2.6 points in the active medication group and from 9.5 ± 1.3 to 6.1 ± 4.1 points in the placebo group (P < 0.001), indicating superiority of EPs 7630 over placebo. Conclusions: EPs 7630 was found to be efficacious in the treatment of acute tonsillopharyngitis in children and was very well tolerated.

Symptomatic treatment of acute tonsillo-pharyngitis patients with a combination of Nigella sativa and Phyllanthus niruri extract

Acute tonsillopharyngitis is characterized by tonsil or pharyngeal inflammation and mostly is a virus in origin; thus, treatment that covers both the inflammation and inadequate immune response against the pathogenic organism is needed. NSPN extract containing Nigella sativa and Phyllanthus niruri extracts has both antiinflammatory and immunomodulatory effects. A comparative, parallel, randomized, double-blind, placebo-controlled study with a treatment period of 7 days was conducted to examine clinical effectiveness of Nigella sativa and Phyllanthus niruri extract (NSPN extract). Of 200 enrolled patients, 186 patients completed the study, 12 patients withdrew and 2 patients were principally screened failure but inadvertently included. NSPN capsules, each containing 360 mg Nigella sativa and 50 mg Phyllanthus niruri extracts, were orally administered 3 times 1 capsule daily for 7 days. At Hour 5 or 6 of the first dosing of study medication, the sore throat assessed as swallowing pain and difficulty, was markedly alleviated in the NSPN group. In line with the significant alleviation of pain, from Days 0 to 2 of treatment, subjects in the NSPN group also needed significantly less escape âanalgesicâ therapy (paracetamol tablets) than those in the placebo group. At the end of treatment (Day 7), a significantly greater proportion of patients in the NSPN group than in the placebo group had their sore throat completely relieved. NSPN extract was also found to be safe and well tolerated in acute tonsillopharyngitis patients. This study proved significant benefits of NSPN extract in the treatment of acute tonsillopharyngitis as compared to placebo.

Cefadroxil versus penicillin in the treatment of streptococcal tonsillopharyngitis

In a randomized multicentre study the efficacy of phenoxymethyl-penicillin and cefadroxil was tested in the treatment of acute tonsillopharyngitis caused by group A streptococci. These organisms were detected in 269 of the 300 children studied. Of the 239 patients in whom results could be evaluated, 121 received penicillin and 118 cefadroxil. After ten days of therapy the microbiological failure rate was 19% in the penicillin group and 6.8% in the cefadroxil group (p less than 0.01). Ten of 23 cases of microbiological failure in the penicillin group and two of eight in the cefadroxil group also had clinical symptoms of infection. All streptococcal isolates were sensitive to penicillin, cefadroxil and clindamycin with the exception of one strain with intermediate sensitivity to cefadroxil. Seven strains had intermediate sensitivity to erythromycin and one was resistant. No penicillin tolerance was observed. Patients in whom penicillin therapy failed more frequently had beta-lactamase producing staphylococci in the pharyngeal flora in comparison to successfully treated patients. The clinical and bacteriological results showed that cefadroxil was clearly superior to penicillin.