Improving the effectiveness of treatment of acute and exacerbations of chronic pharyngitis with the inclusion of bacterial lysate mixtures in complex therapy

Introduction. Various forms of chronic pharyngitis are of the greatest interest for practical otorhinolaryngology. This is due to the prevalence of nosological forms, the peculiarities of the etiopathogenetic mechanisms of the disease, and the variability of the clinical course. The irrational use of drugs with antibacterial and local anti-inflammatory effects often leads to the devel­opment of resistance of many pathogenic microorganisms, changes in the composition of the normal microbiota of the lymphat­ic formations of the pharyngeal ring and the formation of local dysbiosis, which can be avoided by using immunomodulatory drugs based on bacterial cell lysates.

Aim. To investigate the clinical efficacy and safety of bacterial lysates in the treatment and prevention of acute and exacerba­tions of chronic pharyngitis.

Materials and methods. A total of 11 patients with a verified diagnosis of acute and exacerbation of chronic pharyngitis were examined. To achieve this goal, traditional therapy was supplemented with immunocorrection and the appointment of bacterial lysates. When choosing a medicinal product, literary sources were used that highlight topical issues of the development of acute and exacerbations of chronic pharyngitis, clinical manifestations, treatment prevention. Due to the small sample of patients, statistical processing was not carried out and is reflected in a subsequent publication with a larger sample of patients.

Results and discussion. It is noted that the use of bacterial cell lysates, allows achieving better results relative to traditional treat­ment methods. It was noted that the pronounced stimulating capabilities of local and systemic immunity, a drug based on bacterial cell lysates, restores the barrier functions of the mucous membranes at an early stage and reduces the frequency of exacerba­tions. Due to the existing difference in terminology and the most frequent use of the term “chronic tonsillopharyngitis” by foreign sources, the majority of the material is presented by domestic literature sources. The work is supported by two clinical examples.

Conclusions. The inclusion of bacterial lysates in the complex therapy of acute and exacerbations of chronic pharyngitis will make it possible to achieve recovery and improve the quality of life at an earlier date.

1. Tovmasyan AS, Filina EV, Golubeva LI, Golovatyuk AA, Ramazanov SR, Polyaeva MYu et al. Chronic pharyngitis. Modern approaches to diagnosis and treatment. Vestnik Oto-Rino-Laringologii. 2023;88(3):56–62. (In Russ.) https://doi.org/10.17116/otorino20228803156.

2. Янов ЮК, Крюков АИ, Дворянчиков ВВ, Носуля ЕВ. Оториноларингология: национальное руководство. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа; 2024. 992 с. https://doi.org/10.33029/9704-8213-1-ORL-2024-1-992.

3. Karpishchenko SA, Krivopalov AA, Eremin SA, Shapkina PA, Chufistova AV. Topical antimicrobial therapy of infectious and inflammatory diseases of the nose and paranasal sinuses. RMJ. 2020;(5):26–30. (In Russ.) Available at: https://www.rmj.ru/articles/otorinolaringologiya/Topicheskaya_antimikrobnaya_terapiya_infekcionno-vospalitelynyh_zabolevaniy_nosa_i_okolonosovyh_pazuh/.

4. Shul’zhenko AE, Zuikova IN, Shchubelko RV. Issues of treatment and prevention of recurrent inflammatory diseases of the upper respiratory tract: An immunologist’s view. A review. Terapevticheskii Arkhiv. 2024;96(11):1076–1082. (In Russ.) https://doi.org/10.26442/00403660.2024.11.203033/

5. 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.

6. Dyukova IA, Yastremskii AP, Volodeev AV. Combination treatments of patients with chronic rhinosinusitis with nasal polyps. Rossiiskaya Otorinolaringologiya. 2024;23(2):25–30. (In Russ.) https://doi.org/10.18692/1810-4800-2024-2-25-30.

7. Hoffman VV, Dvoryanchikov VV. Bacteriologic and immunologic status in patients with chronic tonsillitis current position. Rossiiskaya Otorinolaringologiya. 2013;(6):19–23. (In Russ.) Available at: https://cyberleninka.ru/article/n/bakteriologicheskie-i-immunologicheskiepokazateli-u-bolnyh-hronicheskim-tonzillitom-v-sovremennyh-usloviyah.

8. Ryazantsev SV, Krivopalov AA, Eremin SA, Shapkina 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.

9. 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.

10. Lengina MA, Korkmazov MU, Karpov IA, Uchaev DA, Mochalov UA, Vojvodina PA et al. About the undesirable effects of targeted therapy of polypous rhinosinusitis. Russian Journal of Immunology. 2025;28(1):157–162. (In Russ.) https://doi.org/10.46235/1028-7221-16970-OTA.

11. Sivokhin DA, Svistushkin VM, Schennikova ES, Danelyan ER, Knyazheskaya NP, Kameleva AA. Assessment of the quality of life of patients with polypous rhinosinusitis and bronchial asthma treated with biological therapy. Rossiiskaya Otorinolaringologiya. 2025;24(2):57–64. (In Russ.) Available at: https://www.elibrary.ru/bmvkjp.

12. Van der Velden AW, Sessa A, Altiner A, Pignatari ACC, Shephard A. Patients with Sore Throat: A Survey of Self-Management and Healthcare-Seeking Behavior in 13 Countries Worldwide. Pragmat Obs Res. 2020;11:91–102. https://doi.org/10.2147/POR.S255872.

13. Slesareva EG, Chistyakova YuN, Vologzhanin DA, Golota AS, Dvoryanchikov VV, Kamilova TA, Shcherbak SG. Role of epithelium in pathogenesis of chronic rhinosinusitis with nasal polyps: cells and mediators. Rossiiskaya Otorinolaringologiya. 2024;23(1):66–74. (In Russ.) https://doi.org/10.18692/1810-4800-2024-1-66-74.

14. Гофман ВР, Черныш АВ, Дворянчиков ВВ. Хронический тонзиллит. М.: Техносфера; 2015. 140 с.

15. Podkopaeva YuYu, Krivopalov AA. Сurrent understanding of the diagnosis and treatment of chronic bilateral laryngeal paralytic stenosis. Rossiiskaya Otorinolaringologiya. 2013;(6):146–155. (In Russ.) Available at: https://med-click.ru/uploads/files/docs/sovremennye-predstavleniyao-diagnostike-i-lechenii-hronicheskih-dvustoronnih-paraliticheskih-stenozovgortani-literaturnyy-obzor.pdf.

16. Krivopalov AA, Yanov YuK, Shatalov VA, Rubin AN, Shcherbuk AYu, Artyushkin SA et al. Clinicodiagnostic features of otorhinosinusogenic intracranial pyoinflammatory diseases complicated by sepsis. Grekov’s Bulletin of Surgery. 2016;175(6):13–19. (In Russ.) https://doi.org/10.24884/0042-4625-2016-175-6-13-19.

17. Krivopalov AA, Yanov Yu K, Shcherbuk YuA, Artyushkin SA, Tuzikov NA, Vakhrushev SG et al. Epidemiology of oto- and rhinosinusogenic intracranial complications in the Russian Federation. The Russian Neurosurgical Journal named after Professor A.L. Polenov. 2015;(Suppl. 7):31–33. (In Russ.) Available at: https://www.elibrary.ru/vvnjci.

18. Pavlova SS, Korneenkov AA, Dvorianchikov VV, Ryazantsev SV, Ryazantseva ES, Donskaya OS. Assessment of population health losses due to nasal obstruction based on the concept of the global burden of disease: general approaches and research directions. Meditsinskiy Sovet. 2021;(12):138–145. (In Russ.) https://doi.org/10.21518/2079-701X-2021-12-138-145.

19. Глазников ЛА, Дворянчиков ВВ, Егоров ВИ, Сыроежкин ФА, Буйнов ЛГ, Мельник АМ. Медицинская помощь при травмах лор-органов в условиях чрезвычайных ситуаций. В: Victims in emergency situations. Management, trauma and PTSD, pharmacology, rehabilitation, innovations. Нью-Йорк; 2014. С. 260–320. Режим доступа: https://www.elibrary.ru/uakfbn.

20. Kim IA, Trukhin DV, Sukhostavtseva TV. Possibilities of using bacterial lysates in the treatment and prevention of upper respiratory tract infectious diseases. Russian Rhinology. 2024;32(4):314–322. (In Russ.) https://doi.org/10.17116/rosrino202432041314.

21. Dvoryanchikov VV, Akhmetzyanov IM, Mironov IV, Gavrilov EK, Zinkin VN, Gushchin PS. Features of the acoustic situation in the operation of weapons and military equipment in the armed forces. Bulletin of the Russian Military Medical Academy. 2018;63(3):105–110. (In Russ.) Available at: https://www.elibrary.ru/jspkau.

22. Dvoryanchikov VV, Yanov YuK, Govorun MI. On the issue of the stage-bystage treatment of patients with chronic purulent otitis media. Journal of Ear, Nasal and Throat Diseases. 2004;(6):9–13. (In Russ.) Available at: http://elib.fesmu.ru/Article.aspx?id=124887.

23. Portenko EG, Trigubenko RA, Dobrynin KB. Immune mechanisms in infection-dependent allergic rhinitis: Role of cytokines and chemokines. Rossiiskaya Otorinolaringologiya. 2024;23(6):20–23. (In Russ.) Available at: https://www.elibrary.ru/ityxmb.

24. Lengina MA, Kornova NV, Korkmazov AM, Patrakova DS, Patrakova MS. An excursion into the history of monoclonal antibodies, the possibility of their use in people with a history of polypous rhinosinusitis and severe bronchial asthma. Rossiiskaya Otorinolaringologiya. 2024;23(5):94–106. (In Russ.) Available at: https://www.elibrary.ru/ccgkbg.

25. Hisamova AA, Giesinger OA, Kornova NV, Zyryanova KS, Korkmazov AM, Beloshangin AS. Studies of immunological and microbiological efficiency of the therapy of curcumin and methionine in the developed capsules. Russian Journal of Immunology. 2021;24(2):305–310. (In Russ.) https://doi.org/10.46235/1028-7221-1001-SOI.

26. Williams MR, Greene G, Naik G, Hughes K, Butler CC, Hay AD. Antibiotic prescribing quality for children in primary care: an observational study. Br J Gen Pract. 2018;68(667):90–96. https://doi.org/10.3399/bjgp18X694409.

27. Korkmazov MYu, 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.

28. Braido F, Melioli G, Nicolini G, Ferraris M, Di Girolamo S, Di Gioacchino M, Canonica GW. Sublingually administered bacterial lysates: rationale, mechanisms of action and clinical outcomes. Drugs Context. 2024;13:2024-1-5. https://doi.org/10.7573/dic.2024-1-5.

29. Takács AT, Bukva M, Bereczki C, Burián K, Terhes G. Diagnosis of Epstein-Barr and cytomegalovirus infections using decision trees: an effective way to avoid antibiotic overuse in paediatric tonsillopharyngitis. BMC Pediatr. 2023;23(1):301. https://doi.org/10.1186/s12887-023-04103-0.

30. Mustafa Z, Ghaffari M. Diagnostic Methods, Clinical Guidelines, and Antibiotic Treatment for Group A Streptococcal Pharyngitis: A Narrative Review. Front Cell Infect Microbiol. 2020;10:563627. https://doi.org/10.3389/fcimb.2020.563627.

31. Korkmazov MYu, Lengina MA, Korkmasova M, Kravchenko A.Yu. 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.

32. Rich SN, Prosperi M, Klann EM, Codreanu PT, Cook RL, Turley MK. Evaluating the Diagnostic Paradigm for Group A and Non-Group A Streptococcal Pharyngitis in the College Student Population. Open Forum Infect Dis. 2021;8(11):ofab482. https://doi.org/10.1093/ofid/ofab482.

33. Aziminia N, Hadjipavlou M, Philippou Y, Pandian SS, Malde S, Hammadeh MY. Vaccines for the prevention of recurrent urinary tract infections: a systematic review. BJU Int. 2019;123(5):753–768. https://doi.org/10.1111/bju.14606.

34. Lengina MA, Krivopalov AA, Yastremsky AP, Talibov AKh, Burnashov YaV. Physiological aspects of presbyacoussis onset in students depending on lifestyle and condition of the upper respiratory tract: rehabilitation and prevention. Human. Sport. Medicine. 2022;22(3):181–191. (In Russ.) https://doi.org/10.14529/hsm220322.

35. Esposito S, Soto-Martinez ME, Feleszko W, Jones MH, Shen KL, Schaad UB. Nonspecific immunomodulators for recurrent respiratory tract infections, wheezing and asthma in children: a systematic review of mechanistic and clinical evidence. Curr Opin Allergy Clin Immunol. 2018;18(3):198–209. https://doi.org/10.1097/ACI.0000000000000433.

36. Weissmann G, Smolen JE, Korchak HM. Release of inflammatory mediators from stimulated neutrophils. N Engl J Med. 1980;303(1):27–34. https://doi.org/10.1056/NEJM198007033030109.

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

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

39. Luchikhin LA. The use of imunocorrection therapy for the combined treatment of the inflammatory diseases of the pharynx. Vestnik Oto-Rino-Laringologii. 2012;77(5):48–51. (In Russ.) Available at: https://www.mediasphera.ru/issues/vestnik-otorinolaringologii/2012/5/030042-46682012511.

40. Savenkova MS. The experience with the application of bacterial lysates in the clinical practice of a pediatrician and otorhinolarynologist. Vestnik Oto-Rino-Laringologii. 2012;77(5):73–77. (In Russ.) Available at: https://www.mediasphera.ru/issues/vestnik-otorinolaringologii/2012/5/030042-46682012518.

41. Selimzyanova LR. Role of the topic bacterial lysates in the pediatric practices. Pediatric Pharmacology. 2009;6(2):26–30. (In Russ.) Available at: https://www.pedpharma.ru/jour/article/view/1013.

42. Rebrova SA, Budkova MA, Ryazantsev SV. Hypereosinophilia during dupilumab treatment in patients with severe uncontrolled chronic rhinosinusitis with nasal polyps. Rossiiskaya Otorinolaringologiya. 2025;24(1):21–29. (In Russ.) Available at: https://www.elibrary.ru/xifecf.

43. 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 Oto-Rino-Laringologii. 2022;87(4):102–106. (In Russ.) https://doi.org/10.17116/otorino202287041102.

44. Lewnard JA, King LM, Fleming-Dutra KE, Link-Gelles R, Van Beneden CA. Incidence of Pharyngitis, Sinusitis, Acute Otitis Media, and Outpatient Antibiotic Prescribing Preventable by Vaccination Against Group A Streptococcus in the United States. Clin Infect Dis. 2021;73(1):e47–e58. https://doi.org/10.1093/cid/ciaa529.

45. Knoderer CA, Abi-Mansour TV, Zahn SO, Cornelius A, Richardson K, Fletcher MV et al. Assessment of Pharyngitis Management at a University Student Health Services Clinic. J Pharm Pract. 2021;34(4):612–617. https://doi.org/10.1177/0897190019889433.

46. Kryshen KL, Kukharenko AE, Vichare AS, Gaidai EA, Kryshen AA, Gushchin YaA. et al. Anti-inflammatory and immunomodulating effects of the bacterial lysate in the in vivo models of aseptic lymphadenitis and pneumococcal pneumonia. Medical Immunology (Russia). 2020;22(1):111–122. (In Russ.) https://doi.org/10.15789/1563-0625-AAI-1758.

47. Starostina SV, Svistushkin VM. Wide possibilities of topical therapy in the treatment of patients with infectious and inflammatory diseases of the pharynx. Meditsinskiy Sovet. 2024;18(18):24–30. (In Russ.) https://doi.org/10.21518/ms2024-469.

48. Sobolev VP, Sinkov EV, Svistushkin MV, Eremeeva KV, Zinchenko IA. Topical bacterial lysates in the treatment of patients with infectious and inflammatory diseases of the ENT organs. Meditsinskiy Sovet. 2025;19(7):54–64. (In Russ.) https://doi.org/10.21518/ms2025-111.