Possibilities of local therapy by fixed pharmaceutical combinations in managing patients with acute tonsillopharyngitis


DOI: https://dx.doi.org/10.18565/therapy.2024.10.152-162

Svistushkin V.M., Nikiforova G.N., Toldanov A.V., Shustrova A.N., Kulikova E.D., Sinkov E.V., Zolotova A.V., Shevchik E.A.

1) I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University); 2) Scientific and Technological Center of Unique Instrument Engineering of the Russian Academy of Sciences, Moscow
Abstract. One of the most common symptoms of upper respiratory tract diseases is a sore throat pain caused by the development of acute tonsillopharyngitis (ATP) of various etiologies. Most often, this condition is caused by viruses, not bacterial agents. Currently, much attention is paid to the development of alternative methods for treating ATP to reduce the frequency of irrational antibiotic therapy. Topical drugs with etiological, pathogenetic and symptomatic mechanisms of action, i.e. local drugs with antimicrobial, antiseptic, anti-inflammatory and analgesic properties, are also of great importance. According to the results of the study presented in this article, use of Lysobact COMPLETE® spray allows effectively and safely achieve a significant therapeutic effect in patients with ATP, which is confirmed, among other things, by objective indexes.

Literature


1. Клинические рекомендации. Острый тонзиллит и фарингит (Острый тонзиллофарингит). Национальная медицинская ассоциация оториноларингологов, Союз педиатров России, Межрегиональная ассоциация по клинической микробиологии и антимикробной химиотерапии, международная общественная организация «Евро-Азиатское общество по инфекционным болезням». Рубрикатор клинических рекомендаций Минздрава России. 2024. ID: 306. Доступ: https://cr.minzdrav.gov.ru/recomend/306_3 (дата обращения – 12.12.2024). (Clinical guidelines. Acute tonsillitis and pharyngitis (Acute tonsillopharyngitis). National Medical Association of Otorhinolaryngologists, Union of Pediatricians of Russia, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy, Euro-Asian Society for Infectious Diseases. Rubricator of clinical guidelines of the Ministry of Healthcare of Russia. 2024. ID: 306. URL: https://cr.minzdrav.gov.ru/recomend/306_3 (date of access – 12.12.2024) (In Russ.)).


2. Krüger K., Töpfner N., Berner R. et al. Clinical practice guideline: Sore throat. Dtsch Arztebl Int. 2021; 118(11): 188–94.


https://doi.org/10.3238/arztebl.m2021.0121. PMID: 33602392. PMCID: PMC8245861.


3. Oliver J., Wadu E.M., Pierse N. et al. Group A Streptococcus pharyngitis and pharyngeal carriage: A meta-analysis. PLoS Negl Trop Dis. 2018; 12(3): e0006335.


https://doi.org/10.1371/journal.pntd.0006335. PMID: 29554121. PMCID: PMC5875889.


4. Shulman S.T., Bisno A.L., Clegg H.W. et al.; Infectious Diseases Society of America. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012; 55(10): e86–102.


https://doi.org/10.1093/cid/cis629. PMID: 22965026. PMCID: PMC7108032.


5. Little P., Hobbs F.R., Mant D. et al.; PRISM investigators. Incidence and clinical variables associated with streptococcal throat infections: A prospective diagnostic cohort study. Br J Gen Pract. 2012; 62(604): e787–94.


https://doi.org/10.3399/bjgp12x658322. PMID: 23211183. PMCID: PMC3481520.


6. Alper Z., Uncu Y., Akalin H. et al. Diagnosis of acute tonsillopharyngitis in primary care: A new approach for low-resource settings. J Chemother. 2013; 25(3): 148–55.


https://doi.org/10.1179/1973947813y.0000000071. PMID: 23783139.


7. Савлевич Е.Л., Маркус П.В., Анготоева И.Б. с соавт. Причины болевого синдрома при воспалительных заболеваниях ротоглотки. Терапия. 2024; 10(6): 162–168. (Savlevich E.L., Markus P.V., Angotoeva I.B. et al. Causes of pain syndrome in case of oropharynx inflammatory diseases. Terapiya = Therapy. 2024; 10(6): 162–168 (In Russ.)).


https://dx.doi.org/10.18565/therapy.2024.6.162-168. EDN: VHJZTI.


8. Kenealy T. Sore throat. BMJ Clin Evid. 2014: 2014: 1509. PMID: 24589314. PMCID: PMC3948435.


9. Sidell D. Shapiro N.L. Acute tonsillitis. Infect Disord Drug Targets. 2012; 12(4): 271–76.


https://doi.org/10.2174/187152612801319230. PMID: 22338587.


10. Kanagasabai A, Evans C., Jones H.E. et al. Systematic review and meta-analysis of the accuracy of McIsaac and Centor score in patients presenting to secondary care with pharyngitis. Clin Microbiol Infect. 2024; 30(4): 445–52.


https://doi.org/10.1016/j.cmi.2023.12.025. PMID: 38182052.


11. Rystedt K., Hedin K., Tyrstrup M. et al. Agreement between rapid antigen detection test and culture for group A streptococcus in patients recently treated for pharyngotonsillitis – a prospective observational study in primary care. Scand J Prim Health Care. 2023; 41(1): 91–97.


https://doi.org/10.1080/02813432.2023.2182631. PMID: 36880344. PMCID: PMC10088972.


12. Пальчун В.Т., Крюков А.И., Магомедов М.М. Оториноларингология. Учебник. М.: ГЭОТАР-Медиа. 2019; 592 с. (Palchun V.T., Kryukov A.I., Magomedov M.M. Otorhinolaryngology. Textbook. Moscow: GEOTAR-Media. 2019; 592 pp. (In Russ.)).


ISBN: 978-5-9704-4276-0.


13. Mann J.K., Ndung’u T. The potential of lactoferrin, ovotransferrin and lysozyme as antiviral and immune-modulating agents in COVID-19. Future Virology. 2020; 15(9): 609–24.


https://doi.org/10.2217/fvl-2020-0170.


14. Калюжин О.В. Антибактериальные, противогрибковые, противовирусные и иммуномодулирующие эффекты лизоцима: от механизмов к фармакологическому применению. Эффективная фармакотерапия. 2018; (14): 6–13. (Kalyuzhin O.V. Antibacterial, antifungal, antiviral and immunomodulatory effects of lysozyme: From mechanisms to pharmacological application. Effektivnaya farmakoterapiya = Effective Pharmacotherapy. 2018; (14): 6–13 (In Russ.)). EDN: UUCTTK.


15. Ушкалова Е.А., Зырянов С.К., Затолочина К.Э. Соединения на основе мурамилпептидов в современной медицине: фокус на глюкозаминилмурамил дипептид. Терапевтический архив. 2019; 91(12): 122–127. (Ushkalova E.A., Zyryanov S.K., Zatolochina K.E. Muramyldipeptide-based compounds in current medicine: Focus on glucosaminylmuramyl dipeptide. Terapevticheskiy arkhiv = Therapeutic Archive. 2019; 91(12): 122–127 (In Russ.)).


https://doi.org/10.26442/00403660.2019.12.000471. EDN: EZOONL.


16. Perez S., Velasco-Ortega E., Jiménez-Guerra Á., Aguilera-Navarro E. Cetylpyridinium chloride as a tool against COVID-19. Int J Odontostomat. 2021; 15(1): 27–30.


http://dx.doi.org/10.4067/S0718-381X2021000100027.


17. Государственный реестр лекарственных средств Минздрава России. Инструкция по медицинскому применению лекарственного препарата Лизобакт КОМПЛИТ®. РУ: ЛП-006147 от 17.03.2020. Доступ: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=a0079a64-d4d7-4379-9077-1b0fe6e5e06c (дата обращения – 12.12.2024). (State register of medicines of the Ministry of Healthcare of Russia. Instructions for medical use of the drug Lysobact COMPLETE®. Registration certificate: ЛП-006147 from 03/17/2020. URL: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=a0079a64-d4d7-4379-9077-1b0fe6e5e06c (date of access – 12.12.2024) (In Russ.)).


18. Егоров В.И. Применение лизоцима в лечении фарингитов. В кн.: Егоров В.И., Никулова М.М., Горбаков В.П. Современные методы диагностики и лечения в оториноларингологии. М. 1991; 36–37. (Egorov V.I. The use of lysozyme in the treatment of pharyngitis. In the book: Egorov V.I., Nikulova M.M., Gorbakov V.P. Modern methods of diagnosis and treatment in otorhinolaryngology. Moscow. 1991; 36–37 (In Russ.)).


19. Мухортых В.А. Рациональный подход к терапии при инфекционно-воспалительных заболеваниях верхних дыхательных путей в детском возрасте. РМЖ. Медицинское обозрение. 2021; 5(11): 755–761. (Mukhortykh V.A. The rational treatment approach to infectious inflammatory diseases of the upper respiratory airways in children. Russkiy meditsisnkiy zhurnal. Meditsinskoye obozreniye = Russian Medical Journal. Medical Review. 2021; 5(11): 755–761 (In Russ.)).


https://doi.org/10.32364/2587-6821-2021-5-11-755-761. EDN: LZRCKK.


20. Погорелова О.О., Усенко Д.В., Ардатская М.Д. с соавт. Эффективность Лизобакта в лечении острых респираторных заболеваний у детей. Инфекционные болезни. 2009; 7(1): 69–72. (Pogorelova O.O., Usenko D.V., Ardatskaya M.D. et al. An evaluation of the efficacy of Lysobact in treatment of acute respiratory diseases in children. Infektsionnye bolezni = Infectious Diseases. 2009; 7(1): 69–72 (In Russ.)). EDN: KYFAJV.


21. Карпова Е.П., Гуров А.В., Бурлакова К.Ю. Влияние состава микробиоты носоглотки на эффективность терапии при хроническом аденоидите и экссудативном среднем отите у детей. Вестник оториноларингологии. 2019; 84(6): 100–107. (Karpova E.P., Gurov A.V., Burlakova K.Yu. Possibility of treatment chronic adenoiditis and otitis media with effusion in children, into account the role of the microbiota of the mucous of the nasopharynx. Vestnik otorinolaringolii = Russian Bulletin of Otorhinolaryngology. 2019; 84(6): 100–107 (In Russ.)).


https://doi.org/10.17116/otorino201984061100. EDN: OENSZA.


22. Никифорова Г.Н., Свистушкин В.М., Биданова Д.Б., Волкова К.Б. Эффективность применения комплексных топических препаратов у пациентов с воспалительными заболеваниями глотки. Медицинский совет. 2017; (8): 24–28. (Nikiforova G.N., Svistushkin V.M., Bidanova D.B., Volkova K.B. Efficiency of application of complex topical drugs in patients with inflammatory diseases of the pharynx. Meditsinskiy sovet = Medical Council. 2017; (8): 24–28 (In Russ.)).


https://doi.org/10.21518/2079-701X-2017-8-24-28. EDN: LZULBB.


23. Волков И.Ю., Сагайдачный А.А., Фомин А.В. Фотоплетизмографическая визуализация гемодинамики и двухмерная оксиметрия. Известия Саратовского университета. Новая серия. Серия: Физика. 2022; 22(1): 15–45. (Volkov I.Yu., Sagaidachnyi A.A., Fomin A.V. Photoplethysmographic imaging of hemodynamics and two-dimensional oximetry. Izvestiya Saratovskogo universiteta. Novaya seriya. Seriya: Fizika = Proceedings of the Saratov University. New series. Series: Physics. 2022; 22(1): 15–45 (In Russ.)).


https://doi.org/10.18500/1817-3020-2022-22-1-15-45. EDN: VVFVKY.


About the Autors


Valery M. Svistushkin, MD, Dr. Sci. (Medicine), professor, head of the Department of ear, nose and throat diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 8/2 Trubetskaya St.
E-mail: svvm3@yandex.ru
ORCID: https://orcid.org/0000-0001-7414-1293
Galina N. Nikiforova, MD, Dr. Sci. (Medicine), professor, of the Department of ear, nose and throat diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 8/2 Trubetskaya St.
E-mail: gn_nik_63@mail.ru
ORCID: https://orcid.org/0000-0002-8617-0179
Alexey V. Toldanov, MD, otolaryngologist, head of the surgery block of the Clinic of ear, throat and nose diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 8/2 Trubetskaya St.
E-mail: toldanov@bk.ru
ORCID: https://orcid.org/0000-0002-6164-8594
Anna N. Shustrova, clinical resident of the Department of ear, nose and throat diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 8/2 Trubetskaya St.
E-mail: james.ann@mail.ru
ORCID: https://orcid.org/0000-0001-8850-004X
Evgenia D. Kulikova, research engineer of Scientific and Technological Center of Unique Instrument Engineering of the Russian Academy of Sciences. Address: 117342, Moscow, 15 Butlerova St.
E-mail: jkul2001@gmail.com
ORCID: https://orcid.org/0009-0005-0595-4422
Eduard V. Sinkov, MD, PhD (Medicine), associate professor of the Department of ear, nose and throat diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 8/2 Trubetskaya St.
E-mail: sinkov_e_v@staff.sechenov.ru
ORCID: https://orcid.org/0000-0003-4870-5977
Anna V. Zolotova, MD, PhD (Medicine), associate professor of the Department of ear, nose and throat diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 8/2 Trubetskaya St.
E-mail: zolotova_a_v@staff.sechenov.ru
ORCID: https://orcid.org/0000-0002-3700-7367
Elena A. Shevchik, MD, PhD (Medicine), associate professor of the Department of ear, nose and throat diseases, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 8/2 Trubetskaya St.
E-mail: shevchik_e_a@staff.sechenov.ru
ORCID: https://orcid.org/0000-0002-0051-3792


Similar Articles


Бионика Медиа