An integrated approach to the treatment of acute inflammatory diseases of the larynx
https://doi.org/10.21518/ms2025-078
Abstract
Acute inflammatory diseases of the larynx are a group of the most common diseases among both adults and children, which are caused by a number of infectious and non-infectious factors. Despite the fact that most cases of acute inflammatory diseases of the larynx are viral in nature, treatment often involves unjustified prescribing of systemic antibiotics, which contributes to the development of the problem of antibiotic resistance. The purpose of this article is to conduct an analytical review of existing methods of complex treatment for acute inflammatory diseases of the larynx and new drugs of complex action, the use of which can reduce the need for irrational antibiotic therapy. Immunostimulants boost the innate and acquired immunity, act on both cellular and humoral immunity, activate nonspecific defences and help to develop specific immune response. Bacterial lysates, mixtures of antigens derived from inactivated bacteria representing the most common pathogens, are the most effective group of immunostimulants. The administration of combination immunostimulants may help in enhancing a relief of symptoms of acute inflammatory diseases of the larynx, improve recovery times for patients, reduce systemic antibiotics prescribing rates and decrease the incidence of acute respiratory infections by expanding body’s resistance to various respiratory disease agents.
About the Authors
E. B. Moskvitina
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Ekaterina B. Moskvitina - Cand. Sci. (Med.), Assistant of the Department of Ear, Nose and Throat Diseases, Sechenov First Moscow State Medical University (Sechenov University).
8, Bldg. 2, Trubetskaya St., Moscow, 119991
T. H. Shadyev
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Timur H. Shadyev - Cand. Sci. (Med.), Associate Professor of the Department of Ear, Nose and Throat Diseases, Sechenov First Moscow State Medical University (Sechenov University).
8, Bldg. 2, Trubetskaya St., Moscow, 119991
E. R. Danelian
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Elizaveta R. Danelian - Student of the N.V. Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University).
8, Bldg. 2, Trubetskaya St., Moscow, 119991
References
1. Starostina SV, Sivokhin DA. Systemic antibiotic therapy of patients with acute bacterial sinusitis taking into account resistance. Meditsinskiy Sovet. 2021;(18):172–177. (In Russ.) https://doi.org/10.21518/2079-701X-2021-18-172-177.
2. Svistushkin VM, Nikiforova GN, Shevchik EA, Zolotova AV, Nikiforova AN, Sivokhin DA. Efficacy of herbal medicines in the treatment of acute respiratory infections in real clinical practice. Consilium Medicum. 2022;24(9): 579–587. (In Russ.) https://doi.org/10.26442/20751753.2022.9.201944.
3. Krivopalov AA, Ryazantsev SV, Shatalov VA. New possibilities of therapy and prevention of complications of infectious-inflammatory diseases of the upper respiratory tract. Meditsinskiy Sovet. 2016;(18):24–32. (In Russ.) https://doi.org/10.21518/2079-701X-2016-18-24-32.
4. Gupta G, Mahajan K. Acute Laryngitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available at: https://pubmed.ncbi.nlm.nih.gov/30521292.
5. Morozova SV, Rakunova EB, Sivokhin DA, Litvinova EP. Management of acute inflammatory diseases of the upper respiratory tract with cough. Meditsinskiy Sovet. 2022;16(8):34–39. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-8-34-39.
6. Kavookjian H, Irwin T, Garnett JD, Kraft S. The Reflux Symptom Index and Symptom Overlap in Dysphonic Patients. Laryngoscope. 2020;130(11):2631–2636. https://doi.org/10.1002/lary.28506.
7. Stachler RJ, Francis DO, Schwartz SR, Damask CC, Digoy GP, Krouse HJ et al. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol Head Neck Surg. 2018;158(1):1–42. https://doi.org/10.1177/0194599817751030.
8. Янов ЮК, Крюков АИ, Дворянчиков ВВ, Носуля ЕВ (ред.). Оториноларингология. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа; 2024. 992 с.
9. Chen C, You Y, Du Y, Zhou W, Jiang D, Cao K et al. Global epidemiological trends in the incidence and deaths of acute respiratory infections from 1990 to 2021. Heliyon. 2024;10(16):e35841. https://doi.org/10.1016/j.heliyon.2024.e35841.
10. Таточенко ВК, Бакрадзе МД, Бомбардирова ЕП, Давыдова ИВ, Катосова ЛК, Киселевич ОК и др. Болезни органов дыхания у детей. М.: ПедиатрЪ; 2012. 480 с.
11. Fu M, Gong Z, Li C, Ling K, Zhu Y, Li H et al. Appropriate use of antibiotics for acute respiratory infections at primary healthcare facilities in China: a nationwide cross-sectional study from 2017 to 2019. Lancet Reg Health West Pac. 2023;40:100880. https://doi.org/10.1016/j.lanwpc.2023.100880.
12. McDonagh MS, Peterson K, Winthrop K, Cantor A, Lazur BH, Buckley DI. Interventions to reduce inappropriate prescribing of antibiotics for acute respiratory tract infections: summary and update of a systematic review. J Int Med Res. 2018;46(8):3337–3357. https://doi.org/10.1177/0300060518782519.
13. Guitor AK, Wright GD. Antimicrobial resistance and respiratory infections. Chest. 2018;154(5):1202–1212. https://doi.org/10.1016/j.chest.2018.06.019.
14. Torumkuney D, Mayanskiy N, Edelstein M, Sidorenko S, Kozhevin R, Morrissey I. Results from the survey of antibiotic resistance (SOAR) 2014–16 in Russia. J Antimicrob Chemother. 2018;73(5):14–21. https://doi.org/10.1093/jac/dky065.
15. Reveiz L, Cardona AF. Antibiotics for acute laryngitis in adults. Cochrane Database Syst Rev. 2015;(5):CD004783. https://doi.org/10.1002/14651858.CD004783.pub5.
16. Thomas M, Bomar PA. Upper respiratory tract infection. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available at: https://pubmed.ncbi.nlm.nih.gov/30422556.
17. Abdel-Aty Y, Sulica L. Increased incidence of ulcerative laryngitis during spring 2022 omicron-variant wave of COVID19. J Voice. 2023:S0892- 1997(23)00125-X. https://doi.org/10.1016/j.jvoice.2023.04.003.
18. Gotovyakhina TV, Stepanova YE, Koren EE. Impact of COVID-19 pandemic on laryngeal morbidity. Rossiiskaya Otorinolaringologiya. 2022;21(4):29–34. (In Russ.) https://doi.org/10.18692/1810-4800-2022-4-29-34.
19. Makhotkina NN, Stepanova YuE. Acutelaryngitis. Modern aspects of physiotherapy treatment with syndromic and pathogenetic approach. 2022;21(6):114–119. Rossiiskaya Otorinolaringologiya. (In Russ.) https://doi.org/10.18692/1810-4800-2022-6-114-119.
20. Santos Martín MT, Ruiz Camacho M, Rodríguez García C, Álvarez Triano M, González Vila L. Streptococcus pyogenes as an etiological agent of acute epiglottitis. An Pediatr (Engl Ed). 2023;99(6):438–439. https://doi.org/10.1016/j.anpede.2023.05.012.
21. Tovar Padua LJ, Cherry JD. Croup (Laryngitis, Laryngotracheitis, Spasmodic Croup, Laryngotracheobronchitis, Bacterial Tracheitis, and Laryngotracheob ronchopneumonitis) and Epiglottitis (Supraglottitis). In: Feigin and Cherry’s Textbook of Pediatric Infectious Diseases. 2025.
22. Ficke B, Rajasurya V, Sanghavi DK, Cascella M. Chronic Aspiration. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available at: https://pubmed.ncbi.nlm.nih.gov/32809569.
23. Costa E, Pazinatto DB, Trevisan LP, Maunsell R. Post-extubation laryngitis in children: diagnosis, management and follow-up. Braz J Otorhinolaryngol. 2024;90(4):101440. https://doi.org/10.1016/j.bjorl.2024.101440.
24. Dworkin-Valenti JP, Sugihara EM, Stern N, Naumann IC, Bathula SS, Amjad EH. Laryngeal inflammation. Ann Otol Rhinol Laryngol. 2015;2(9):1058.
25. Dworkin JP. Laryngitis: types, causes, and treatments. Otolaryngol Clin North Am. 2008;41(2):419–436. https://doi.org/10.1016/j.otc.2007.11.011.
26. Rinsky-Halivni L, Klebanov M, Lerman Y, Paltiel O. Adherence to voice therapy recommendations is associated with preserved employment fitness among teachers with work-related dysphonia. JVoice. 2017;31(3):386. https://doi.org/10.1016/j.jvoice.2016.09.011.
27. Uraskulovа BB, Gyusan AO. Experience in the use of the drug “Aqua Maris Strong for Throat” in the complex treatment of inflammatory diseases of the larynx. Rossiiskaya Otorinolaringologiya. 2022;21(3):148–154. https://doi.org/10.18692/1810-4800-2022-3-148-154.
28. Huestis MJ, Keefe KR, Kahn CI, Tracy LF, Levi JR. Alternatives to acid suppression treatment for laryngopharyngeal reflux. Ann Otol Rhinol Laryngol. 2020;129(10):1030–1039. https://doi.org/10.1177/0003489420922870.
29. Svistushkin VM, Starostina SV, Avetisyan EE, Selezneva LV. Possibilities of immunostimulating therapy in respiratory infections of upper respiratory tracts. Meditsinskiy Sovet. 2017;(8):8–12. (In Russ.) https://doi.org/10.21518/2079-701X-2017-8-8-12.
30. Jurkiewicz D, Zielnik-Jurkiewicz B. Bacterial lysates in the prevention of respiratory tract infections. Otolaryngol Pol. 2018;72(5):1–8. https://doi.org/10.5604/01.3001.0012.7216.
31. Steele A, Stacey HJ, de Soir S, Jones JD. The safety and efficacy of phage therapy for superficial bacterial infections: A systematic review. Antibiotics (Basel). 2020;9(11):754. https://doi.org/10.3390/antibiotics9110754.
32. La Mantia I, Nicolosi F, Maiolino L, Serra A. Immunoprophylaxis of recurring bacterial infections of respiratory tracts in pediatric age: clinical experience through a new immunostimulating vaccine. GIMMOC Quaderni di Microbiologia e Clinica. 2007;11(2):1–8.
Review
For citations:
Moskvitina EB, Shadyev TH, Danelian ER. An integrated approach to the treatment of acute inflammatory diseases of the larynx. Meditsinskiy sovet = Medical Council. 2025;(7):31-35. (In Russ.) https://doi.org/10.21518/ms2025-078
Views:
143
Email this article 