Current aspects of the treatment of acute tonsillopharyngitis: the place of topical therapy

Abstract

The problem of acute tonsillopharyngitis remains relevant despite a huge amount of research. According to modern clinical guidelines, practically the only indication for prescribing systemic antibacterial therapy remains the GAS etiology of acute tonsillopharyngitis. At the same time, in clinical practice there are often cases of patients independently and unjustifiably starting to take systemic antibacterial drugs due to severe pain, which they were unable to relieve with the use of topical drugs. Most cases of acute tonsillopharyngitis are of a viral etiology. According to the modern guidelines, there is almost the one and only indication for antibiotics in patients with acute tonsillitis. Taking into account, the timing of a standard microbiological study, special clinical scales are used to quickly assess the clinical picture, according to which the patient scores a certain number of points depending on whether certain criteria are met. The most widely used is the McIsaac scale, which takes into account, in addition to the clinical picture, the patient’s age. At the same time, in clinical practice there are often cases of patients independently and unjustifiably starting to take systemic antibacterial drugs due to severe pain, which they were unable to relieve with the use of topical drugs. Thus, timely prescription of topical drugs effective for pain relief occupies an important place in the management of patients with both viral and bacterial acute tonsillopharyngitis. The article presents a series of clinical cases of acute tonsillopharyngitis, which can be characterized by the complexity of differential diagnosis. Using their own observations as an example, the authors demonstrate the importance of timely effective topical therapy, in particular with the antiseptic drug Mitraseptin-PRO (benzyldimethylmyristoylaminopropylammonium).