Tonsillopharyngitis. The role of local anti-inflammatory therapy
https://doi.org/10.21518/2079-701X-2018-6-56-60
Abstract
The article presents the diagnostic and therapeutic features of acute tonsillopharyngitis (ATP) taking into account the viral and bacterial aetiology of the disease. It discusses the cases when the systemic antibacterial therapy should be prescribed, considers various approaches to assessing the aetiology of ATP, evaluation of clinical signs and symptoms included in the Centor scores and rapid diagnostics tests. It stresses that the use of antibiotics should be strictly justified taking into account the proven bacterial aetiology of the disease or suspicion on the same. In most cases, systemic antibiotic therapy is not necessary, since viral tonzillofaringitis is more common than bacterial. At the same time, drugs for local therapy - antiseptics, topical antibiotics, nonsteroidal anti-inflammatory drugs, which reduce local manifestations of inflammatory reaction in the pharynx, become more important. The efficacy of Septolete total tablets containing a non-steroidal anti-inflammatory agent benzidamine and an antiseptic agent cetylpyridinium chloride is proved on clinical cases.
References
1. Абдулкеримов Х.Т., Гаращенко Т.И., Кошель В.И., Рязанцев С.В., Свистушкин В.М. Тонзилло-фарингиты: методические рекомендации под редакцией С.В. Рязанцева. М., СПб.: Полифорум Групп, 2014: 40.
2. Canli H, Saatci E, Bozdemir N, Akpinar E, Kiroglu M. The antibiotic prescribing behavior of physicians for acute tonsillopharyngitis in primary care. Ethiop Med J, 2006, 44 (2): 139-143.
3. González Fernández N, Herrero-Morín JD, Solís Sánchez G, Pérez Méndez C, Molinos Norniella C, Pardo de la Vega R, Crespo Hernández M. Variability of antibiotic treatment in paediatric acute pharyngotonsillitis in Asturias, Spain. Arch Argent Pediatr, 2012, 110(3): 207-213. doi: 10.1590/S0325-00752012000300003.
4. Мальцева Г.С. Особенности стрептококковой инфекции при хроническом тонзиллите. Consilium Medicum, 2010, 11: 26-29.
5. Крюков А.И., Ивойлов А.Ю., Кулагина М.И., Кравчук А.П. Острый тонзиллит у детей. Диагностика, прогностическое значение, современное лечение. Consilium Medicum, 2015, 3: 56-59.
6. Оториноларингология. Национальное руководство под ред. В.Т. Пальчуна. М.: ГЭОТАР-Медиа. 2008: 120-278.
7. Ball S.L. Expression and immunolocalisation of antimicrobial peptides within human palatine tonsils. J. Laryngol. Otol., 2007, 121 (10): 973-978.
8. Соболева Ю.В., Фадеев С.Б. Межмикробные взаимодействия стрептококков с ассоциантами на слизистой оболочке небных миндалин. Современные проблемы науки и образования, 2013, 6: 58. Электронный научный журнал. https://www.science-education.ru/ru/article/ view?id=10827.
9. Hsieh Tsung-Hsueh, Chen Po-Yen, Huang Fang-Liang, Wang Jiann-Der, Wang Li-Ching, Lin Heng-Kuei, Lin Hsiao-Chuan, Hsieh Hsin-Yang, Yu Meng-Kung, Chang Chih-Feng, Chuang Tzu-Yau, Lee Chin-Yun Are empiric antibiotics for acute exudative tonsillitis needed in children? Journal of Microbiology, Immunology and Infection, 2011, 44: 328-332.
10. Proenca-Modena JL, Pereira Valera FC, Jacob MG, Buzatto GP, Saturno TH, Lopes L, Souza JM, Escremim Paula F, Silva ML, Carenzi LR, Tamashiro E, Arruda E, Anselmo-Lima WT. High rates of detection of respiratory viruses in ton-sillar tissues from children with chronic adenotonsillar disease. PLoS One, 2012, 7(8): 421-436. doi: 10.1371/journal.pone.0042136.
11. American Academy of Otolaryngology–Head and Neck Surgery. http://www.entnet.org/content/tonsillitis. Дата обращения 25.11.2017.
12. Burton MJ, Glasziou PP, Chong LU, Venekamp RP. Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev, 2014, 19(11): CD001802.
13. Paradise JL, Bluestone CD, Colborn DK, Bernard BS, Rockette HE, Kurs-Lasky M. Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics, 2002, 110: 7–15.
14. Jeong JH, Lee DW, Ryu RA, Lee YS, Lee SH, Kang JO, Tae K. Bacteriologic сomparison of tonsil core in recurrent tonsillitis and tonsillar hypertrophy. Laryngoscope, 2007, 117: 2146–2151.
15. Di Pierro F, Adami T, Rapacioli G, Giardini N, Streitberger C. Clinical evaluation of the oral probiotic Streptococcus salivarius K12 in the prevention of recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes in adults. Expert Opin. Biol. Ther., 2013, 13(3): 339– 343. doi: 10.1517/14712598.2013.758711.
16. Centor RM, Witherspoon JM, Dalton HP, Brody CE, Link K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making, 1981; 1 (3): 239-246.
17. Mclsaac WJ, White D, Tannenbaum D, Low DE. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ, 1998, 158(1): 75-83.
18. Hersh AL, Jackson MA, Hicks LA and the COMMITTEE ON INFECTIOUS DISEASES. Principles of Judicious Antibiotic Prescribing for Upper Respiratory Tract Infections in Pediatrics. Pediatrics, 2013, 132: 1146–1154.
19. Ehlers Klug T, Rusan M, Fuursted K, Ovesen T. Fusobacterium necrophorum: most prevalent pathogen in peritonsillar abscess in Denmark. Clin Infect Dis, 2009, 49: 1467-1472.
20. Batty A., Wren M.W., Gal M. Fusobacterium necrophorum as the cause of recurrent sore throat: comparison of isolates from persistent sore throat syndrome and Lemierre’s disease. J Infect, 2005, 51: 299-306.
21. Зайченко А.В. Боль в горле. Рекомендации клинического провизора. Фармацевт Практик, 2013, 2: 38-39.
Review
For citations:
Shilenkova VV. Tonsillopharyngitis. The role of local anti-inflammatory therapy. Meditsinskiy sovet = Medical Council. 2018;(6):56-60. (In Russ.) https://doi.org/10.21518/2079-701X-2018-6-56-60
Views:
830
Email this article 