Conceptual issues of using topical antiseptics in uncomplicated oropharyngeal infections

Introduction. Pharyngitis is one of the most common reasons for patients to seek medical care from a general practitioner and an otorhinolaryngologist. In this case, drugs with a proven mechanism of action and a high safety profile are considered an etiopathogenetically justified component of topical therapy for uncomplicated cases of the disease.

Aim. To evaluate the effectiveness of using an antiseptic with the active ingredient ambazone as part of local therapy for acute uncomplicated pharyngitis of infectious etiology.

Materials and methods. During 2025, 67 patients aged 20 to 45 (32 ± 1.2) with a diagnosis of acute pharyngitis (J02) were examined. The effectiveness of treatment was assessed based on complaints, pharyngoscopy results, and quality of life indicators using the SF-36 questionnaire. All patients were divided into two groups. The patients in the main group, in contrast to the control group, received ambazone in addition to standard conservative therapy (antiviral and non-steroidal anti-inflammatory drugs, anti-inflammatory herbal drugs, and elimination therapy). The treatment duration was 4 days.

Results and discussion. On the 2nd day after the end of the course of treatment, patients in the group receiving ambazone in addition to standard therapy had pharyngoscopy without hyperemia of the pharyngeal mucosa, hyperemia of the palatine tonsils, mucous plaque on the pharyngeal mucosa, “granularity” of the posterior pharyngeal wall, swelling of the uvula, while the group receiving standard therapy had hyperemia of the pharyngeal mucosa was expressed by 1.6 points, hyperemia of the palatine tonsils – by 1.8 points, mucous plaque on the pharyngeal mucosa – by 1.2 points, “granularity” of the posterior pharyngeal wall – by 1.3 points, swelling of the uvula – by 1.0 points.

Conclusions. The conducted clinical study and the presented clinical example demonstrate the high efficacy profile of an ambazone in the treatment of uncomplicated acute pharyngitis.

1. Янов ЮК, Крюков АИ, Дворянчиков ВВ, Носуля ЕВ (ред.) Оториноларингология: национальное руководство. Краткое издание. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа; 2024. 992 с. Режим доступа: https://www.rosmedlib.ru/sl/book/ISBN9785970482131.html.

2. Горохов АА, Янов ЮК, Дворянчиков ВВ, Миронов ВГ. Оториноларингология. 2-е изд., испр. и доп. СПб.: СпецЛит; 2019. 224 с. Режим доступа: https://www.books-up.ru/ru/book/otorinolaringologiya-9085725/.

3. Krukov AI, Gurov AV, Yushkina MA, Izotova GN. Peculiarities of clinical course of inflammatory diseases of the oropharynx of various etiologies and possibilities of local therapy. Vestnik Otorinolaringologii. 2019;84(5):68–72. (In Russ.) https://doi.org/10.17116/otorino20198405168.

4. Mizernitskiy YuL, Melnikova IM. Modern therapy of acute respiratory viral infections and influenza in children: how to resist polypharmacy? Pediatrics. Consilium Medicum. 2018;(3):69–73. (In Russ.) Available at: https://omnidoctor.ru/library/izdaniya-dlya-vrachey/pediatriya-consiliummedicum/ped2018/ped2018_3/sovremennaya-terapiya-ostrykhrespiratornykh-virusnykh-infektsiy-i-grippa-u-detey-kak-protivostoyat-/.

5. Korkmazov M Yu, Yastremsky AP, Kornova NV, Lengina MA, Korkmazov AM. Therapeutic and diagnostic approaches in the treatment of chronic tonsillitis. Meditsinskiy Sovet. 2022;16(20):90–99. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-20-90-99.

6. Savenkova MS. Influenza and other acute respiratory viral infections in children. Aspects of antiviral therapy. Pediatrics. Consilium Medicum. 2016;(3):73–78. (In Russ.) Available at: https://omnidoctor.ru/library/izdaniya-dlya-vrachey/pediatriya-consilium-medicum/ped2016/ped2016_3/gripp-i-drugie-ostrye-respiratornye-virusnye-infektsii-u-detey-aspektyprotivovirusnoy-terapii/.

7. Дайхес НА, Баранов АА, Лобзин ЮВ, Намазова-Баранова ЛС, Козлов РС, Поляков ДП и др. Острый тонзиллит и фарингит (Острый тонзиллофарингит): клинические рекомендации. М.; 2024. 55 с. Режим доступа: https://cr.minzdrav.gov.ru/view-cr/306_3.

8. Savlevich EL, Doroschenko NE, Slavinskaya IS, Farikov SE. Important factors of the inflammatory process in the oropharynx and optimal treatment regimes selection. Meditsinskiy Sovet. 2017;(16):48–54. (In Russ.) https://doi.org/10.21518/2079-701X-2017-16-48-54.

9. Korkmazov MYu, Lengina MA, Dubinets ID, Korkmazov AM, Smirnov A. Quality of life of children with allergic rinitis and ways of correction. Meditsinskiy Sovet. 2023;17(19):115–124. (In Russ.) https://doi.org/10.21518/ms2023-379.

10. Savlevich EL, Brodovskaya OB, Remizova II, Chistjakova GN, Ischenko AM, Simbirtsev AS. Clinical and immunological aspects of the application of the new aerosol form of recombinant interferon α2b in the treatment of patients with acute nasopharingitis. Citokiny i Vospalenie. 2010;9(1):49–56. (In Russ.) Available at: https://elibrary.ru/ogagej.

11. Radtsig EYu, Gurov AV. Sore throat. Crossing problems and finding solutions. Russian Journal of Woman and Child Health. 2022;5(3):228–236. (In Russ). https://doi.org/10.32364/2618-8430-2022-5-3-228-236.

12. Korkmazov MYu, Lengina MA, Korkmazov AM, Kravchenko AYu. Effect of post-COVID syndrome on the quality of life of patients with allergic rhinitis and eosinophilic phenotype of chronic polyposis rhinosinusitis. Medical Journal of the Russian Federation. 2023;29(4):277–290. (In Russ.) https://doi.org/10.17816/medjrf472079.

13. Ryabichenko TI, Skosyreva GA, Obukhova OO, Kurskaya OG, Kosyanova TG, Gorbenko OM, Shvayuk AP. Etiological structure of acute respiratory viral infections in children hospitalized in 2015-2018. Infectious Diseases: News, Opinions, Training. 2021;10(2):47–53. (In Russ.) https://doi.org/10.33029/2305-3496-2021-10-2-47-53.

14. Savlevich EL, Gaganov LV, Egorov VI, Kurbacheva OM, Mitrofanova ES, Pelishenko TG, Lyubimova EV. Application of eosinophil-neutrophil index ENI and degree of inflammatory infiltration to assess the inflammatory process in polypous rhinosinusitis. Rossiiskaya Otorinolaringologiya. 2022;21(5):70–81. (In Russ.) https://doi.org/10.18692/1810-4800-2022-5-70-81.

15. Korkmazov MYu, Angelovich MS, Lengina MA, Belousov SYu. Clinical case of angiosarcoma of ethmoidal labyrinth and frontal sinus, issues of morphological verification of diagnosis. Vestnik Otorinolaringologii. 2022;87(4):102–106. (In Russ.) https://doi.org/10.17116/otorino202287041102.

16. Meskina EP, Stashko TV. How to reduce the antibacterial load in the treatment of acute tonsillitis and pharyngitis? Possible tactics and practical approaches. Vestnik Otorinolaringologii. 2020;85(6):90–99. (In Russ.) https://doi.org/10.17116/otorino20208506190.

17. Kirilyuk AA. Clinical pharmacology features of the drugs to treat throat and oral cavity diseases. Vestnik Farmacii. 2023;(1):48–70. (In Russ.) Available at: https://vestnik-pharm.vsmu.by/rezyume/2023-1-48-70.

18. Krukov AI, Kunel’skaya NL, Tsarapkin GYu, Izotova GN, Tovmasyan AS. Topical preparations for therapy of tonsillar pathology. Russian Bulletin of Otorhinolaryngology. 2015;80(3):47–49. (In Russ.) https://doi.org/10.17116/otorino201580347-49

19. Kryukov EV, Zhdanov KV, Kozlov KV, Kravtsov VYu, Mal’tsev OV, Sukachev VS et al. Electron microscopic changes in the nasal membrane of patients with COVID-19 depending on the clinical form and the period of the disease. Jurnal Infektologii. 2021;13(2):5–13. (In Russ.) https://doi.org/10.22625/2072-6732-2021-13-2-5-13.

20. Popadyuk VI, Karpov IA, Lengina MA, Korkmazov AM, Kornova NV. Seawater with silver ions in the elimination therapy of polypous sinusitis. Meditsinskiy Sovet. 2025;19(7):46–53. (In Russ.) https://doi.org/10.21518/ms2025-133.

21. Izotov BB, Seleznev AB, Dvorianchikov BB. Peculiarities of tonal audiometric of persons, subjective to influence of low frequency acoustic fluctuations. Rossiiskaya Otorinolaringologiya. 2009;(4):64–68. (In Russ.) Available at: https://elibrary.ru/mhwpot.

22. Korkmazov MYu, Zyryanova KS, Beloshangin AS. Evaluation of the clinical efficacy of a phytotherapeutic drug in the treatment and prevention of recurring acute rhinosinusitis in children of Chelyabinsk. Meditsinskiy Sovet. 2016;(7):90–93. (In Russ.) https://doi.org/10.21518/2079-701X2016-07-90-93.

23. Gofman VV, Dvorynchikov VV. Bacteriologic and immunologic status in patients with chronic tonsillitis current position. Russian otorhinolaryngology. 2014;(2):19–23. (In Russ.) Available at: https://elibrary.ru/ryyuil.

24. Korkmazov MYu, Lengina MA. The need for additional rehabilitation methods for patients with cochleo-vestibular dysfunction. Vestnik Otorinolaringologii. 2012;(S5):76–77. (In Russ.) Available at: https://elibrary.ru/yncybq.

25. Kiparisova DG, Kiparisov YuS, Nurieva NS. Impact of oral hygiene on the development of oropharyngeal neoplasms. Head and Neck Tumors. 2015;5(2):39–44. (In Russ.) https://doi.org/10.17650/2222-1468-2015-5-2-39-44.

26. Lengina MA, Korkmazov MYu, Karpov IA, Uchaev DA, Mochalov YuA, Voevodina PA, Trikula OV. About adverse events of targeted therapy for polypous rhinosinusitis. Russian Journal of Immunology. 2025;28(1):157–162. (In Russ.) https://doi.org/10.46235/1028-7221-16970-OTA.

27. Антипенко ВС, Бадалов ВИ, Бойко ЭВ, Борисов МБ, Бояринцев ВВ, Гаврилин СВ и др. Военно-полевая хирургия. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа; 2016. 768 с. Режим доступа: http://elibrary.ru/yhytdx.

28. Korkmazov MYu, Kornova NV, Lengina MA, Smirnov AA, Korkmazov AM, Dubinets ID. Effective antibiotic therapy for community-acquired otorhinolaryngological respiratory infection (clinical description). Meditsinskiy Sovet. 2022;16(20):73–81. (In Russ.) https://doi.org/10.21518/2079-701X2022-16-20-73-81.

29. Mantica G, Cai T, Medina J, Kranz J, Bonkat G. Antibiotic-sparing Strategies for Prevention of Recurrent Urinary Tract Infection. Eur Urol Focus. 2024;10(5):700–701. https://doi.org/10.1016/j.euf.2024.07.008.

30. Korkmazov MYu. Chronic tonsillitis and analysis of physical methods of exposure. Vestnik Otorinolaringologii. 2006;(S5):299–300. (In Russ.) Available at: https://elibrary.ru/sicbel.

31. Nurieva NS, Vazhenin AV. Dental care for patients with head and neck cancer. Siberian Journal of Oncology. 2009;(2):75–78. (In Russ.) Available at: https://onco.tnimc.ru/upload/zhurnal/soj_2009_2_75-78.pdf.

32. Kiparisov YS, Nurieva NS. Experimental study of the effectiveness of fixing forming and replacing prostheses of acquired defects in the maxillofacial region. Clinical Dentistry (Russia). 2018;(1):68–71. (In Russ.) https://doi.org/10.37988/1811-153X_2018_1_68.

33. Krivopalov AA, Moroz NV, Belicheva EG, Lengina MA. Phage therapy in overcoming antibiotic resistance in chronic rhinosinusitis. Vestnik Otorinolaringologii. 2023;88(6):48–55. (In Russ.) https://doi.org/10.17116/otorino20238806148.

34. Korkmazov AM. The topical issues of the treatment of the patients presenting with rhinosurgical problems during the early postoperative period. Russian Rhinology. 2018;26(1):38–42. (In Russ.) https://doi.org/10.17116/rosrino201826138-42.

35. Ryazantsev SV, Krivopalov AA, Eremin SA, Shamkina PA. Topical antibacterial therapy in the inflammatory diseases treatment of the nasal cavity, paranasal sinuses, and complications prevention. RMJ. 2019;(8-1):55–59. (In Russ.) Available at: https://www.rmj.ru/articles/otorinolaringologiya/Topicheskaya_antibakterialynaya_terapiya_v_lechenii_vospalitelynyh_zabolevaniy_polosti_nosa_okolonosovyh_pazuh_i_profilaktike_osloghneniy/.

36. Krivopalov AA, Moroz NV, Artyushkin SA, Shamkina PA, Zakharova GP. Assessment of prevalence of chronic rhinosinusitis. Rossiiskaya Otorinolaringologiya. 2022;21(5):91–98. (In Russ.) https://doi.org/10.18692/1810-4800-2022-5-91-98.

37. Korkmazov MYu, Lengina MA, Dubinets ID, Kravchenko AYu, Klepikov SV. Some immunological aspects of targeted therapy in polypous rhinosinusitis. Russian Journal of Immunology. 2023;26(3):301–306. (In Russ.) https://doi.org/10.46235/1028-7221-8955-SIA.

38. Vladimirova TYu, Lazareva LA, Martynova AB. Modern aspects of treatment of acute tonsillopharyngitis. Meditsinskiy Sovet. 2024;18(18):49–55. (In Russ.) https://doi.org/10.21518/ms2024-468.

39. Korkmazov AM, Dubinets ID, Lengina MA. Possibilities of topical antioxidant protection of operated cavities in practical otorhinolaryngology. Vestnik Otorinolaringologii. 2017;82(S5):14–15. (In Russ.) Available at: https://elibrary.ru/ylwhjs.

40. Dubinets ID, Korkmazov MYu, Korkmazov AM, Sinitskii AI, Mokina MV. Personalized prediction of the results of reconstructive surgery for chronic otitis media. Meditsinskiy Sovet. 2022;16(4):146–155. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-4-146-155.

41. Zakharova IN, Berezhnaya IV, Kuznetsova IS, Dubovets NF. Possibilities of using ambazone (Faringosept) in infectious and inflammatory diseases of oropharynx. A review. Pediatrics. Consilium Medicum. 2024;(1):37–42. (In Russ.) https://doi.org/10.26442/26586630.2024.1.202596.

42. Kladova OV, Shamsheva OV. Clinically proven effectiveness of the antiseptic agent Faringosept® (Ambazon) over a long period of its use in medical practice. Paediatrician Practice. 2017;(4):29–33. (In Russ.) Available at: https://medi.ru/docplus/5958.pdf.

43. Timofeev AA. The use of Pharyngosept for the prevention of postextraction inflammatory complications in patients with acute chronic periodontitis. Dentist-Practitioner. 2011;(2):48–51. (In Russ.) Available at: https://medbusiness.ru/ Images/Stomatolog_1_2015_50-53.pdf.

44. Svistushkin VM, Morozova SV, Kozlova LA. Symptomatic therapy for acute infectious and inflammatory diseases of the pharynx. Meditsinskiy Sovet. 2024;18(7):10–14. (In Russ.) https://doi.org/10.21518/ms2024-093.

45. Andriyanova IV, Ilyenkova NA, Vakhrushev SG, Romanova NI. Microbiota of the upper respiratory tract in children with chronic adenoiditis. Consilium Medicum. 2023;25(12):834–837. (In Russ.) https://doi.org/10.26442/20751753.2024.12.202570.

46. Löber G, Hoffmann H. Ambazone as a membrane active antitumor drug. Biophys Chem. 1990;35(2-3):287–300. https://doi.org/10.1016/03014622(90)80016-z.

47. Döring M. Mutagenic activity of ambazone in bacterial test systems. Stud Biophys. 1987;117(1):99–104.

48. Brook I. The role of β-lactamase-producing bacteria in the persistence of streptococcal tonsillar infection. Rev Infect Dis. 1984;6(5):601–607. https://doi.org/10.1093/clinids/6.5.601.

49. Kuhnel HJ, Hoffmann H, Kaufmann K, Kossovich J. Amabazone is a potential second-generation anticancer agent. Zbl Pharm Pharmakother Lab Diagn. 1989;128(2):65–71.

50. Muresan-Pop M, Kacso I, Tripon C, Moldovan Z, Borodi Gh, Simon S, Bratu I. Spectroscopic and structural study of ambazone hydrochloride. J Therm Anal Calorim. 2011;104:299–306. https://doi.org/10.1007/s10973-010-1171-4.