Sore throat with acute respiratory viral infection: New possibilities of topical therapy

Introduction. A sore throat is one of the most common symptoms of acute respiratory viral infections (ARVI).

Aim. To evaluate the clinical efficacy of Miramistin as part of combination therapy in patients with a sore throat associated with ARVI.

Materials and methods. The study was conducted in a sample of 57 patients (mean age 36.6 ± 8.0 years) with documented acute tonsillopharyngitis due to ARVI. The treatment group (28 patients, mean age 39.5 ± 6.4 years) was treated by irritation of the oropharynx with benzyldimethyl-myristoylamino-propylammonium spray, 4-fold pressing 4 times a day for 5 days. The control group (29 patients, mean age 33.9 ± 8.4 years) was prescribed standard ARVI therapy with antiviral and antipyretic drugs. The general and local symptoms of the disease were assessed using a 3-point scale and the pharyngoscopic view of patients was monitored. In addition, the outcomes of treatment were assessed by the doctor and the patients using integral scales (IMPSS, IMOS).

Results and discussion. On day 5, the number of patients with complete sore throat relief was 85.7% in the treatment group and 69.0% in the control group; complaints of discomfort in swallowing were completely resolved in 85.7% of patients in the treatment group and in 72.4% of patients in the control group. On day 5, all patients in the treatment group showed significant improvement and minimal changes in their pharyngoscopic view as compared to the control group, which had persistent hyperemia, swelling of the oropharyngeal mucosa, and the presence of reddish lymphoid follicles on the posterior pharyngeal wall.

Conclusions. The data obtained indicate the importance of using antiseptic drugs as part of the combination ARVI therapy.

1. Wang X, Li Y, O’Brien KL, Madhi SA, Widdowson MA, Byass P et al. Global burden of respiratory infections associated with seasonal influenza in children under 5 years in 2018: a systematic review and modelling study. Lancet Glob Health. 2020;8(4):e497–e510. https://doi.org/10.1016/S2214-109X(19)30545-5.

2. Zaytseva SV, Zaytseva OV. Acute respiratory infections: the impact of the interaction between respiratory viruses on the disease course and outcomes. Clinical Review for General Practice. 2023;4(4):73–81. (In Russ.) https://doi.org/10.47407/kr2023.4.4.00259.

3. Jumanova LA, Khantturaeva MYu. Study of the epidemiological dynamics of arvi over the last ten years. Economics and Society. 2024;(3-1):631–634. (In Russ.) Available at: https://www.iupr.ru/_files/ugd/b06fdc_b67012dac2ca42938be246eb3ddbb084.pdf

4. Larina VN, Zakharova MI, Benevskaya VF, Golovko MG, Soloviev SS. Acute respiratory viral infections and influenza: etiology, diagnosis and treatment algorithm. RMJ. Medical Review. 2019;(9-1):18–23. (In Russ.) Available at: https://www.rusmedreview.com/upload/iblock/47f/18-23.pdf.

5. Denisova AR, Maksimov ML. Acute respiratory viral infections: etiology, diagnosis, modern view of treatment. RMJ. Medical Review. 2018;(1-2):99–103. (In Russ.) Available at: https://www.rusmedreview.com/upload/iblock/233/99-103.pdf.

6. Ismail H, Schellack N. Colds and flu – an overview of their management. SA Pharm J. 2017;84(2):15–22. https://doi.org/10.4102/safp.v59i3.4704.

7. Angotoeva IB. Differential diagnosis of throat pain. Meditsinskiy Sovet. 2014;(15):42–47. (In Russ.) Available at: https://www.med-sovet.pro/jour/article/view/744.

8. Baranov KK, Kotova EN, Vyazmenov EO, Protasov AA. Differentiated approach to diagnostics and treatment of combined pathology of the pharynx, larynx and rhino-orbital zone: interdisciplinary interaction. Consilium Medicum. 2023;25(9):589–595. (In Russ.) https://doi.org/10.26442/20751753.2023.9.202416.

9. Ovchinnikov AYu, Miroshnichenko NA, Nikolaeva YuO. Sore throat. Recent trends in treatment. Vestnik Oto-Rino-Laringologii. 2020;85(4):35 39. (In Russ.) https://doi.org/10.17116/otorino20208504135.

10. Wang Y, Eccles R, Bell J, Chua AH, Salvi S, Schellack N et al. Management of acute upper respiratory tract infection: the role of early intervention. Expert Rev Respir Med. 2021;15(12):1517–1523. https://doi.org/10.1080/17476348.2021.1988569.

11. Дайхес НА, Баранов АА, Лобзин ЮВ, Намазова-Баранова ЛС, Козлов РС, Поляков ДП и др. Острый тонзиллит и фарингит (острый тонзиллофарингит): клинические рекомендации. M.; 2024. Режим доступа: https://glav-otolar.ru/assets/images/docs/clinical-recomendations/KR306%20Tonzillofaringit.pdf.

12. Kholodova IN. Modern approach to diagnostics and individual acute tonsillopharyngitis in children. Remedium Privolzhye. 2020;(4-5):24–28. (In Russ.) Available at: https://medialnn.ru/?id=18881.

13. Fromm-Dornieden C, Rembe J.-D, Schäfer N, BohmJ, Stuermer EK. Cetylpyridinium chloride and miramistin as antiseptic substances in chronic wound management – prospects and limitations. J Med Microbiol. 2015;64(4):407–414. https://doi.org/10.1099/jmm.0.000034.

14. Dunaevsky AM, Kirichenko IM. A clinical study of Myramistin application in the treatment of infectious and inflammatory diseases of the respiratory system. Lechaschi Vrach. 2014;(10):65–69. (In Russ.) Available at: https://www.lvrach.ru/2014/10/15436075.

15. Zyryanov SK, Baybulatova EA. Clinical and pharmacological analysis of antiseptic used in practical medicine. Clinical Practice in Pediatrics. 2021;16(6): 77–92. (In Russ.) https://doi.org/10.20953/1817-7646-2021-6-77-92.

16. Maltseva GS. Antiseptic agents in the practice of ENT specialist. Lechebnoe Delo. 2017;(4):16–20. (In Russ.) Available at: https://www.atmosphere-ph.ru/modules/Magazines/articles/delo/ld_4_2017_16.pdf.

17. Krivorutchenko IuL. Dose-dependent inactivation of extracellular human immunodeficiency virus by miramistin. Vopr Virusol. 1998;43(3):122–124. Available at: https://pubmed.ncbi.nlm.nih.gov/9702810/.

18. Rún Sigurðardóttir N, Nielsen AB, Munck A, Bjerrum L. Appropriateness of antibiotic prescribing for upper respiratory tract infections in general practice: Comparison between Denmark and Iceland. Scand J Prim Health Care. 2015;33(4):269–274. https://doi.org/10.3109/02813432.2015.1114349.

19. Osmanov A, Wise A, Denning DW. In vitro and in vivo efficacy of miramistin against drug-resistant fungi. J Med Microbiol. 2019;68(7):1047–1052. https://doi.org/10.1099/jmm.0.001007.

20. Svistushkin VM, Mokoyan ZT, Svistushkin MV, Sagova DI. Current aspects of the treatment of acute tonsillopharyngitis: the place of topical therapy. Meditsinskiy Sovet. 2023;17(19):100–107. (In Russ.) https://doi.org/10.21518/ms2023-356.

21. Karpischenko SA, Kolesnikova OM. Modern solution in the treatment of acute tonsillopharyngitis. RMJ. 2023;(1):46–50. (In Russ.) Available at: https://www.rmj.ru/articles/otorinolaringologiya/Sovremennoe_reshenie_v_lechenii_ostrogo_tonzillofaringita/.

22. Artyushkin SA, Yanov YuK, Ryazantsyev SV, Eremina NV, Artyushkina VK, Eremin SA. The results of a 5-year clinical and epidemiological study of the National Program “Chronic tonsillitis”. Vestnik Oto-Rino-Laringologii. 2024;89(6):28 39. (In Russ.) https://doi.org/10.17116/otorino20248906128.