Possibilities of pathogenetic treatment of rhinosinusitis patients: Efficacy and safety of phytotherapy

Rhinosinusitis is a common group of inflammatory diseases of the nose and paranasal sinuses that have a significant impact on the health and quality of life of patients. Despite the frequent appointment of systemic antibiotic therapy for rhinosinusitis, this etiotropic treatment is not indicated in most patients, and pathogenetic treatment is rational in almost all clinical cases. To evaluate the efficacy and safety of phytotherapy, including the standardized drug myrtol, in the treatment of patients with rhinosinusitis according to literature data. A literature review was performed using the databases PubMed, Scopus, eLIBRARY. RU and Cochrane Library for the keywords: “rhinosinusitis”, “phytotherapy”, “Myrtol standardized extract”, “pathogenetic treatment”. Both experimental studies and clinical observations are considered. It has been demonstrated that systemic antibiotic therapy is indicated only in a small proportion of patients with rhinosinusitis who have a moderate to severe bacterial process. The main focus is on pathogenetic treatment, including mucoactive, anti-inflammatory and secretolytic drugs. Phytotherapy, in particular standardized myrtol extract, demonstrates evidence of improved mucociliary clearance, decreased inflammatory response, and symptom relief in the experiment. Clinical studies confirm the safety and efficacy of standardized myrtol extract in acute and chronic rhinosinusitis, with minimal risk of adverse events. Pathogenetic treatment using standardized phytotherapy is a promising method of managing patients with rhinosinusitis. Standardized myrtol extract can be recommended as a safe and effective drug, especially in patients without indications for systemic antibiotics.

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