Local treatment options for sore throat in children
https://doi.org/10.21518/2079-701X-2020-18-72-79
Abstract
Sore throat is a common complaint among children and adults. In addition to infection, causes of sore throat include non-infectious pathological conditions. Among possible causes are viruses, bacteria, fungal flora. Identification of etiology significantly affects the disease management. The prescription of systemic antimicrobial agents is justified, if bacterial etiology is confirmed or a child develops complications; the presence of β-hemolytic streptococcus is an absolute indication for antibiotic therapy. Increasingly greater attention is now paid to topical agents in the treatment of bacterial tonsillopharyngitis, in particular, to the drugs that combine the antiseptic and antibiotic properties. The article provides data on the use of a combination drug containing antibacterial substance gramicidin S and antiseptic component cetylpyridinium chloride that proved its efficacy, safety, and low risk of side effects in pediatric and adult patient population. The authors present their own clinical observations of the successful use of this combination drug in paediatric practice.
Clinical case 1. A 15-year-old child K. with a polyvalent drug allergy to antibacterial drugs. Moderately grave condition, subfebrile temperature 37.8 oC; submandibular lymph nodes increased up to 2.0 cm with expressed tenderness; preliminary diagnosis is acute tonsillopharyngitis; Infectious mononucleosis?». Pharyngoscopy showed bright hyperemia of edematous mucous membrane, hyperemia of enlarged palatine tonsils, visualized white plaque; single vesicular rashes on the anterior palatine arches and uvula. The patient received active etiotropic, pathogenetic and symptomatic therapy. Instead of systemic antibacterial therapy, a combination drug based on gramicidin S and antiseptic component cetylpyridinium chloride was chosen. The patient was discharged from the hospital on Day 10 of hospitalization, the child had no complaints, the general condition returned to normal.
Clinical case 2. A 6-year-old child was diagnosed with acute pharyngitis, degree II palatine tonsils hypertrophy, degree II nasopharyngeal tonsil hypertrophy, submandibular and cervical lymphadenitis. The laboratory test results showed absence of β-hemolytic streptococcus. The combination drug based on gramicidin S and antiseptic component cetylpyridinium chloride was prescribed, the pharyngotonsillitis symptoms disappeared on Day 7 of observation.
Clinical observations demonstrate the possibility of using the combination drug for the complex treatment of acute tonsillopharyngitis of any etiology, including those that develop in childhood.
Clinical case 1. A 15-year-old child K. with a polyvalent drug allergy to antibacterial drugs. Moderately grave condition, subfebrile temperature 37.8 oC; submandibular lymph nodes increased up to 2.0 cm with expressed tenderness; preliminary diagnosis is acute tonsillopharyngitis; Infectious mononucleosis?». Pharyngoscopy showed bright hyperemia of edematous mucous membrane, hyperemia of enlarged palatine tonsils, visualized white plaque; single vesicular rashes on the anterior palatine arches and uvula. The patient received active etiotropic, pathogenetic and symptomatic therapy. Instead of systemic antibacterial therapy, a combination drug based on gramicidin S and antiseptic component cetylpyridinium chloride was chosen. The patient was discharged from the hospital on Day 10 of hospitalization, the child had no complaints, the general condition returned to normal.
Clinical case 2. A 6-year-old child was diagnosed with acute pharyngitis, degree II palatine tonsils hypertrophy, degree II nasopharyngeal tonsil hypertrophy, submandibular and cervical lymphadenitis. The laboratory test results showed absence of β-hemolytic streptococcus. The combination drug based on gramicidin S and antiseptic component cetylpyridinium chloride was prescribed, the pharyngotonsillitis symptoms disappeared on Day 7 of observation.
Clinical observations demonstrate the possibility of using the combination drug for the complex treatment of acute tonsillopharyngitis of any etiology, including those that develop in childhood.
About the Authors
S. A. Karpishchenko
Federal State Budget Institution “Saint Petersburg Research Institute of Ear, Throat, Nose and Speech“ of the Ministry of Health of the Russian Federation;
Federal State Budgetary Educational Institution of Higher Education “Pavlov First Saint Petersburg State Medical University“ of the Ministry of Public Health of the Russian Federation;
Saint Petersburg State-Financed Health Institution “Rauchfus Children’s City Multidisciplinary Clinical Center for High Medical Technologies“
Russian Federation
Russian Federation
Dr. of Sci. (Med.), Professor, Acting Director; Head of Chair for Otorhinolaryngology; Otorhynolaryngologist
9, Bronnitskaya St., St Petersburg, 190013, Russia
6–8, Lev Tolstoy St., St Petersburg, 197022, Russia
8, Ligovskiy Ave., St Petersburg, 191036, Russia
S. I. Alekseenko
Federal State Budget Institution “Saint Petersburg Research Institute of Ear, Throat, Nose and Speech“ of the Ministry of Health of the Russian Federation;
Saint Petersburg State-Financed Health Institution “Rauchfus Children’s City Multidisciplinary Clinical Center for High Medical Technologies“;
Federal State Budgetary Educational Institution of Higher Education “NorthWestern State Medical University named after I.I. Pirogov» of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Senior Researcher, Department of High-Tech Healthcare Technology Development; Head of Otorhinolaryngology Department; Associate Professor, Otorhinolaryngology Department
9, Bronnitskaya St., St Petersburg, 190013, Russia
8, Ligovskiy Ave., St Petersburg, 191036, Russia
41, Ostrovityanova St., Moscow, 191015, Russia
M. V. Drozdova
Federal State Budget Institution “Saint Petersburg Research Institute of Ear, Throat, Nose and Speech“ of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Dr. of Sci. (Med.), leading researcher of the Department of development and implementation of high-tech treatment methods
9, Bronnitskaya St., St Petersburg, 190013, Russia
S. V. Baranskaya
Federal State-Funded Educational Institution of Higher Education “Pavlov First Saint Petersburg State Medical University“ of the Ministry of Public Health of the Russian Federation
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Otorhynolaryngologist of Otorhinolaryngology Department, Junior Researcher of Otorhinolaryngology Department, Research Institute of Surgery and Emergency Medicine, Teaching Assistant of Chair for General Medical Practice (Family Medicine)
6–8, Lev Tolstoy St., St Petersburg, 197022, Russia
References
1. Weber R. Pharyngitis. Prim Care. 2014;41(1):91–98. doi: 10.1016/j.pop.2013.10.010.
2. Miskovic A., Johnson M., Frost L., Fernandez E., Pistorio A., Disma N. A prospective observational cohort study on the incidence of postoperative sore throat in the pediatric population. Paediatr Anaesth. 2019;29(12):1179–1185. doi: 10.1111/pan.13757.
3. Spurling G.K., Del Mar C.B., Dooley L., Foxlee R., Farley R. Delayed antibiotic prescriptions for respiratory infections. Cochrane Database Syst Rev. 2017;9(9):CD004417. doi: 10.1002/14651858.CD004417.pub5.
4. Karpishchenko S.A., Alekseenko S.I., Baranskaya S.V. Treatment of tonsillopharyngitis in children. Meditsinskiy sovet = Medical Council. 2020;(1):70–75. (In Russ.) doi: 10.21518/2079-701X-2020-1-70-75.
5. Kolesnikova O.M., Karpishchenko S.A., Legkova Y.V. Anti-inflammatory therapy of throat diseases. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae. 2019;25(3):53–59. (In Russ.) Available at: https://elibrary.ru/item.asp?id=41240585.
6. Svistushkin V.M., Nikiforova G.N., Toporkova L.A., Karpova O.Yu. Possibilities of topical etiotropic drugs in the treatment of patients with acute tonsillopharyngitis. RMZH = RMJ. 2018;(10):97–102. (In Russ.) Available at: https://www.rmj.ru/articles/otorinolaringologiya/Vozmoghnosti_topicheskih_etiotropnyh_preparatov_v_lechenii_bolynyh_ostrym_tonzillofaringitom.
7. Maltseva G.S., Karpishchenko S.A. The role of herbal medicine in the treatment of chronic tonsillitis. Meditsinskiy sovet = Medical Council. 2020;(6):36–43. (In Russ.) doi: 10.21518/2079-701X-2020-6-36-43.
8. Radford J.R., Beighton D., Nugent Z., Jackson R.J. Effect of use of 0.05% cetylpyridinium chloride mouthwash on normal oral flora. J Dent. 1997;25(1):35–40. doi: 10.1016/s0300-5712(95)00116-6.
9. Geppe N.A., Dronov I.A. Use of topical antiseptics in acute and chronic tonsillopharyngitis in children. Doktor.Ru = Doctor.Ru. 2014;(9–10):71–75. (In Russ.) Available at: https://elibrary.ru/item.asp?id=23369591.
10. Drozdova M.V., Larionova S.N., Tyrnova E.V. Clinical and etiological aspects of the lymphoproliferative syndrome in 2–3-year-old children. Rossiyskaya otorinolaringologiya = Russian Otorhinolaryngology. 2019;18(103):18–25. (In Russ.) doi: 10.18692/1810-4800-2019-6-18-25
Review
For citations:
Karpishchenko SA, Alekseenko SI, Drozdova MV, Baranskaya SV. Local treatment options for sore throat in children. Meditsinskiy sovet = Medical Council. 2020;(18):72-79. (In Russ.) https://doi.org/10.21518/2079-701X-2020-18-72-79
Views:
643
Email this article 