Study of Imupret Application in the Technology of Delayed Prescription of Antibiotics in Patients With Acute Tonsillitis
Status:
Completed
Trial end date:
2020-03-25
Target enrollment:
Participant gender:
Summary
The problem of acute tonsillitis (AT) is one of the most urgent in modern clinical medicine.
The prevalence of pathology ranges from 2 to 15% of the total population.
AT (ICD J03.0-J03.9) in most cases is due to viral infections. Bacterial acute tonsillitis
occurs in immunocompetent children in 20-30% of cases.
To determine the indications for antibacterial therapy, the Mclsaac scale is a commonly used
tool for decision. This scale is used to classify patients according to their symptoms and to
determine the patients for whom antibiotic therapy is not indicated.
Thus, in most cases of acute tonsillitis (even if there are 4-5 points according to the
scale), it has to be taken into account that there is a low probability of the presence of
GABS. Therefore, there are no unconditional indications for the prescription of antibiotics.
Unjustified antibiotic therapy of AT plays a significant role in the formation of antibiotic
resistance.
To prevent unjustified prescription of antibiotics, a therapeutic concept of delayed
administration is proposed. A patient with AT is prescribed treatment with antibiotics in a
delayed manner. In the absence of a positive effect within 36-48 hours from the beginning of
treatment with Imupret, the antibacterial therapy is started. The advantage of deferred
antibiotic prescription is, that a higher number of patients and doctors, awaiting antibiotic
therapy, may be more agreeable with this way of treatment than with a complete rejection of
the antibiotic's prescription. So delayed use of antibiotics is an important treatment
strategy to reduce the number of unreasonable prescriptions of antibiotics.
Considering this fact, it becomes necessary to use drugs with a complex effect and
evidence-based efficacy base for acute tonsillitis. At the moment, there is an insignificant
evidence base for the application of the phytoneering drug Imupret in acute tonsillitis. The
spectrum of its pharmacological properties includes antiviral, antibacterial,
anti-inflammatory, and immunomodulating effects. The combination of these properties makes it
possible to influence practically all parts of acute tonsillitis. The already existing
studies were not conducted under GCP conditions. Confirmation of the high effectiveness of
Imupret in the treatment of acute tonsillitis would serve as a rationale for optimizing the
treatment regimen of this nosology and recommendations for the inclusion of the drug in
national guidelines.