No2(4) 2021
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DOI 10.37219/2528-8253-2021-2-45 |
Al Hariri MJ, Koshel IV, Popovych VI
Clinical and immunological efficiency of bacteriophage in technique of
delayed prescribing of antibiotics in patients with acute post-viral
rhinosinusitis |
Al Hariri Mahmoud Jоmaa
Ivano-Frankivsk National Medical University
Department of Otorhinolaryngology – Head and Neck Surgery
Graduate student
E-mail: alhariri.mahmoud75@gmail.com
ORCID ID: https://orcid.org/0000-0002-8669-7026
Koshel Ivanna V.
Ivano-Frankivsk National Medical University
Associate Professor at the Department of Internal Medicine and Family
Medicine
Doctor of Medical Sciences
ORCID ID: https://orcid.org/0000-0002-5466-4537
Popovych Vasyl I.
Ivano-Frankivsk National Medical University
Head of Department of Otorhinolaryngology – Head and Neck Surgery
Doctor of Medical Sciences, Professor
E-mail: popovychvasyl@gmail.com
ORCID ID: https://orcid.org/0000-0002-2898-8474 |
Abstract Topicality: Acute Rhinosinusitis can be
characterised as acute bacterial rhinosinusitis just in about 0,5 - 2% of
the number of viral one and only such patients need prescription of
antibiotics. At the same time, antibacterial therapy is prescribed in from
54% to 77% cases of Acute Rhinosinusitis. To reduce the number of
unreasonable prescriptions, the strategy of delayed prescribing of
antibioticsis the forward-looking one.
Aim: to evaluate the level of IgА and sIgA in patients with
post-viral RS and estimate the clinical and immunological efficiency of
polyvalent bacteriophage in technique of delayed prescribing of antibiotics
in comparison with the patients receiving standard APVRS therapy.
Material and methods: 155 adult patients with acute post-viral RS
participated in the trial who were given either standard therapy or
polyvalent bacteriophage in addition to the standard therapy. In conjunction
with the treatment, the IgА and sIgA levels were evaluated and their
comparison with clinical dynamics was undertaken.
Evaluation criteria: decrease in intensity of disease symptoms
evaluated in accordance with MSS scale system during each visit in
comparison with the 1st visit, antibiotic prescribing frequency, dynamics of
changes of serum and secretory IgА levels.
Results and discussion: The use of polyvalent bacteriophagein
addition to the standard therapy of acute post-viral rhinosinusitisas a part
of technique of delayed prescribing of antibiotics ensures clinically
significant, faster dynamics of regression of typical clinical symptoms of
post-viral rhinosinusitis: rhinorrhea, nasal congestion and post-nasal drip
in comparison with the control group (p<0.05). Positive dynamics of clinical
symptomatology is followed by the fair increase of IgА and sIgA levels
(p<0.005), in comparison with the level before treatment and the control
group. The statistically significant difference between the control group
and the intervention one in IgА and sIgA indicators is associated with
fairly higher (by 20%) rate of prescribing of antibiotics in the control
group.
Conclusion: polyvalent bacteriophage is a safe and effective
medication for additional treatment of acute post-viral rhinosinusitis
intended to improve indicators of systemic and local immunity and reduce the
rate of use of antibiotics. The inclusion of the medication into the
treatment regimen could be recommended to the patients as a part of
technique of delayed prescribing of antibiotics. |
Keywords
acute rhinosinusitis, polyvalent bacteriophage, delayed antibiotic therapy,
IgА, sIgA. |
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