Combined therapy for infectious and inflammatory diseases of the upper respiratory tract (clinical observation)

The most common upper respiratory tract infections include the following nosologies: rhinitis, rhinosinusitis (sinusitis), nasopharyngitis (rhinopharyngitis), pharyngitis, acute tonsillitis (angina). In recent years, topical antimicrobial drugs are widely used for diseases of the nose and paranasal sinuses, acting in the focus of inflammation with minimal systemic absorption. In most patients, acute bacterial rhinosinusitis is a complication of viral infection with impaired sinus drainage, which can lead to complications and chronic disease. Streptococcus pneumoniae and Haemophilus influenzae are detected in 70–75% of cases, Streptococcus pyogenes in 15–20%, Moraxella catarrhalis, Staphylococcus aureus, anaerobes, etc. According to the literature, the main bacterium is beta-hemolytic group A streptococcus, but the prevalence of asymptomatic colonization with Staphylococcus aureus worldwide ranges from 3.7% to 48.6% (2024). Due to the problem of antimicrobial resistance in pathogens, it is important to use local antibacterial agents in bacterial rhinosinusitis, either in combination with systemic antibiotic therapy or in a different format. In this context, a clinical case illustrating the efficacy of combination therapy in acute purulent rhinosinusitis is presented. An 18-old-patient M. complained of a fever of 37.8°C (99.8°F), nasal obstruction, and purulent nasal discharge. She had been ill for 10 days after ARVI, irrigating her nasal cavities with saline solution without any positive effect. As a result of the treatment, the patient achieved a rapid clinical effect due to the local comprehensive action of framycetin, fixed-dose combination of N-acetylcysteine, tuaminoheptane, and sodium hyaluronate applied with systemic antibiotic therapy.

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