Application of lysozyme and dequalinium chloride in the treatment of acute respiratory diseases of the upper respiratory tract in children

Abstract

Background. Acute viral respiratory infections — a group of the most common diseases that manifest primarily by the catarrhal syndrome with oropharyngeal involvement and require topical application of antiseptics. The purpose was to study the clinical features of pharyngeal and laryngeal lesions in acute respiratory infections in different regions of Ukraine, to evaluate the effectiveness and safety of Lizak on a large clinical material and its ability to influence the activity of native immunity. Materials and methods. 25,229 children aged 4 to 18 years with acute respiratory infections were examined, which manifested by the inflammatory process in the oropharynx. General clinical, immunological, bacteriological studies were carried out. Results. It was established that the use of Lizak in clinical practice is effective and leads to a decrease in the severity of clinical signs of inflammation in the oropharynx, controls dry mouth, pain syndrome, restores the voice function. When studying the correlation between clinical and anamnestic data, it was found that the most significant relationship was observed between tonsillitis and the severity of the temperature response on the first and third days after treatment initiation (r = 0.43 and 0.69, respectively), the presence of tonsillitis also correlated with the intensity of throat pain (r = 0.46) and the presence of cough on day 7 of the disease (r = 0.39). At the same time, the severity of cough on the first and third days of the disease correlated with acute laryngitis (r = 0.51 and 0.36, respectively). Hoarseness correlated with the degree of dryness in the oropharynx (r = 0.47) and was characteristic of laryngitis. To determine the immunological effectiveness of Lizak, 124 children aged 7–12 years with acute respiratory infections and oropharyngeal lesions were examined. It was found that interferon gamma level in the oropharyngeal fluid and blood serum tended to decrease indicating a decrease in the activity of inflammatory process in the oropharynx. It is concluded that Lizak reducing the intensity of the inflammatory process in the oropharynx can influence the level of proinflammatory cytokines, in particular interferon gamma. During the bacteriological examination of the oropharyngeal microflora in patients under observation, an increase in the number of pathogenic and opportunistic microorganisms was observed before the treatment. After the application of Lizak, the microbiocenosis was restored mainly due to a decrease in the number of pathogenic and opportunistic flora (S.aureus, Candida albicans, etc.) and an increase in the number of indigenous flora. Lizak did not have side effects in most cases, although a small number of patients (0.76 %) had signs of allergic reaction (sore throat, uvular edema, unusual taste). The efficacy of Lizak was evaluated by doctors and patients in 99 % of cases as good. Conclusions. Application of Lizak in clinical practice is effective and leads to a decrease in the severity of clinical signs of inflammation in the oropharynx, controls dry mouth, pain syndrome, restores the voice function, reduces the severity of inflammatory process in the oropharynx and affects the level of proinflammatory cytokines, in particular interferon gamma, restores microbiocenosis of the oropharynx by reducing the number of pathogenic and opportunistic flora (S.aureus, Candida albicans, etc.) and increasing the number of indigenous flora. Lizak has good tolerability and is effective in 99 % of cases.