Clinical and immunological efficiency of bacteriophage in technique of delayed prescribing of antibiotics in patients with acute post-viral rhinosinusitis

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.\nAim: 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.\nMaterial 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.\nEvaluation 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.\nResults 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.\nConclusion: 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.