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Pharyngitis is a disorder commonly reported in ENT OPDs. The most common cause of Pharyngitis in India is Group A streptococcus, with prevalence rates of 13% in children aged 5–15%. It can also be attributed to various other bacterial, viral and fungal agents. Oral gargles are increasingly being used as a safe, effective, and non-invasive method for management. The aim of the present study was to evaluate the efficacy of Octenidine gargles in cases of Acute Pharyngitis. The present study is a prospective double blinded randomised study done in a tertiary care hospital in Sitapur, UP between 1st January, 2022 to 30th June, 2022. Patients with acute pharyngitis were randomised into two groups- Octenidine and Placebo group and subsequently, the efficacy of octenidine was studied. The octenidine gargle group reported better improvement acute pharyngitis symptoms and a significantly shorter time to symptom resolution. The study suggests that Octenidine gargles are an effective treatment option for Acute Pharyngitis, providing significant symptom relief and a shorter time to resolution when compared to warm saline gargles. [ABSTRACT FROM AUTHOR]

Abstract Background The Finnish treatment guidelines for sore throat were updated in June 2020. The aim of this study was to determine how the publication of these guidelines affected the treatment of pediatric patients, particularly through the use of the Centor criteria, C-reactive protein tests, and microbiological testing in the diagnosis of Group A β-hemolytic streptococci tonsillitis. Methods We conducted a retrospective single-center before-and-after cohort study in Finland from 2019 to 2022. We included all patients who visited the pediatric emergency department and were diagnosed with tonsillitis or pharyngitis. Results We included 246 patients who were admitted before the guidelines were updated and 219 patients after. Only two patients in the after group had a Centor score reported in their patient records. Rapid antigen tests were administered to 231 patients (93.9%) before the update and 202 patients (92.2%) after (proportion difference of 1.7%, CI -3.0–6.6%). C-reactive protein was taken from 193 patients (78.5%) before the update and 189 patients (86.3%) after (proportion difference of 7.8%, CI 0.1–14.7%). Conclusions Centor scores were not used as recommended in the guidelines and did not impact the use of microbiological or C-reactive protein testing. More education and examining the preconceptions of health care personnel is required to implement the updated treatment guidelines in clinical practice.

Background: The Finnish treatment guidelines for sore throat were updated in June 2020. The aim of this study was to determine how the publication of these guidelines affected the treatment of pediatric patients, particularly through the use of the Centor criteria, C-reactive protein tests, and microbiological testing in the diagnosis of Group A β-hemolytic streptococci tonsillitis. Methods: We conducted a retrospective single-center before-and-after cohort study in Finland from 2019 to 2022. We included all patients who visited the pediatric emergency department and were diagnosed with tonsillitis or pharyngitis. Results: We included 246 patients who were admitted before the guidelines were updated and 219 patients after. Only two patients in the after group had a Centor score reported in their patient records. Rapid antigen tests were administered to 231 patients (93.9%) before the update and 202 patients (92.2%) after (proportion difference of 1.7%, CI -3.0–6.6%). C-reactive protein was taken from 193 patients (78.5%) before the update and 189 patients (86.3%) after (proportion difference of 7.8%, CI 0.1–14.7%). Conclusions: Centor scores were not used as recommended in the guidelines and did not impact the use of microbiological or C-reactive protein testing. More education and examining the preconceptions of health care personnel is required to implement the updated treatment guidelines in clinical practice. [ABSTRACT FROM AUTHOR]

Objective : Acute pharyngitis is common worldwide. Meteorological changes contribute to respiratory infections. This study aims to explore the correlation between acute pharyngitis and meteorological parameters. Methods : We collected the monthly acute pharyngitis cases in our hospital and the meteorological data, including temperature, relative humidity, and air quality index (AQI) of Shanghai, China, from January, 2015, to December, 2017. Pearson correlation and multivariable regression analysis were used to explore the association between meteorological parameters and the monthly hospital visits. Results : A total of 8287 patients were included in this study, and the monthly number of hospital visits was 230.2 ± 39.0. The best air quality index was 46.4 and the worst was 113.2. Temperature ranged from 5.2°C to 32.0°C, and relative humidity ranged from 59.4% to 83.1%. The monthly hospital visits of acute pharyngitis were negatively correlated with temperature (r = −.558, 95% CI −.746, −.274) and relative humidity (r = −.480, 95% CI −.695, −.137). A decrease of 1°C could cause an increase in hospital visits by 1.9. No significant correlation was found were found between acute pharyngitis cases and AQI (P =.051, 95% CI −.005,.590). Multivariable linear regression analysis showed the temperature was the independent risk factor of acute pharyngitis (coefficient = −1.906, P =.022). Conclusion : Low temperature might cause an increased incidence of acute pharyngitis. [ABSTRACT FROM AUTHOR]

IntroductionWith the onset of the COVID-19 pandemic, the incidence and prevalence of acute pharyngitis (AP) have increased significantly. Tinosporae Radix (TR) is a vital medication utilized in the treatment of pharyngeal and laryngeal ailments, especially AP. The study endeavors to explore unclear molecular mechanisms of TR in addressing AP.MethodsNetwork pharmacology and metabolomics analyses of effect of TR on AP were conducted, and apossible pathway was validated both in vivo using the acute pharyngitis rat model and in vitro using the LPS-induced RAW264.7 cells model, through techniques such as histopathological examinations, immunohistochemical technology, ELISA, RT-qPCR, and Western blotting to systematically explore the possible mechanisms underlying the inhibition of AP by TR.Results and discussionNetwork pharmacology analysis identified several key targets, including PIK3CA, IL6, AKT1, TNF, and PTGS2, alongside pivotal signaling pathways such as IL-17, TNF, Hepatitis B, nuclear factor kappa B (NF-κB), Influenza A, and the PI3K-Akt pathway. Most of them are closely associated with inflammation. Then, wide-target metabolomics analysis showed that TR downregulated substances within the glycerophospholipid metabolic pathway, and modulated the PI3K-Akt pathway. The integrated findings from network pharmacology and metabolomics underscored the pivotal role of the PI3K-Akt signaling pathway and the attenuation of inflammatory responses. Finally, in vitro and in vivo experiments have shown that TR can inhibit inflammatory factors such as IL-6, TNF - α, and COX-2, downregulate targets such as PI3K and AKT on the PI3K-Akt signaling pathway, and thereby alleviate the inflammatory response of AP. Our study demonstrated that TR exerts an anti-AP effect through suppression of release of inflammatory factors and modulation of glycerophospholipid metabolism via suppressing the PI3K-Akt signaling pathway.

The burden of group A streptococcus (GAS) infection and its rheumatic sequelae remains dramatically high, especially in low-income countries. Recently, an increased number of Acute Rheumatic Fever (ARF) cases was documented in many regions of Italy. The diagnosis of rheumatic sequelae relies on clinical signs and on the evaluation of the Antistreptolysin O titre (ASO), whose variations are globally reported. To re-examine the standard reference value of ASO titre, by measuring either its upper limit of normal (ULN) in a population of healthy children (HC) or comparing these values with streptococcal antibodies registered in a cohort of patients affected by the rheumatic sequelae of GAS infection. We performed a multicenter retrospective study. We enrolled 125 HC, aged 2–17 years, and a total of 181 patients affected by ARF, acute streptococcal pharyngitis, post-streptococcal arthritis, Henoch-Schönlein purpura and erythema nodosum, divided into four groups. The levels of ASO and anti-deoxyribonuclease B (anti-DNase B) titres were analyzed and compared among the various groups. Moreover, the 80th percentile value was calculated and established as the ULN for ASO titre in HC group. The ULN for ASO titre in overall HC group was 515 IU/mL, resulting in higher than used in the routine investigation. The ASO titre was significantly higher in patients with rheumatic sequelae compared with HC group, with a peak in the age between 5 and 15 years. Conclusion: Our study established a new ULN normal value of streptococcal serology in a childhood and adolescent population of Italy, suggesting the need to extend this revaluation to the critical areas, in order to avoid underestimating ARF diagnosis. The correct interpretation of ASO and anti-DNase B values in the context of rheumatic diseases has been discussed. What is Known: • The global burden of disease caused by group A streptococcus is not known and remains an important cause of morbidity and mortality. Acute rheumatic fever continues to be a serious worldwide public health problem and a recent recurrence of group A streptococcus infection cases is observed. • The streptococcal sequelae requires evidence of preceding streptococcal infection, commonly elevated streptococcal antibody titre, but the upper limit for these titres varies considerably based on age group, region, and origin. What is New: • This study provides population-specific values for streptococcal antibody titres in Italy. • Interpret the results of group A streptococcal antibody tests within the clinical context. [ABSTRACT FROM AUTHOR]

Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Group A streptococcus is found in 20–40% of cases of childhood pharyngitis; the remaining cases are viral. Streptococcal pharyngitis (“strep throat”) is usually treated with antibiotics, while these are not indicated in viral cases. Most guidelines recommend relying on a diagnostic test confirming the presence of group A streptococcus before prescribing antibiotics. Conventional first-line tests are rapid antigen detection tests based on throat swabs. Recently, rapid nucleic acid tests were developed; they allow the detection of elements of the genome of group A streptococcus. We hypothesize that these rapid nucleic acid tests are sensitive enough to be performed on saliva samples instead of throat swabs, which could be more convenient in practice. Methods This is a multicenter, prospective diagnostic accuracy study evaluating the performance of a rapid nucleic acid test for group A streptococcus (Abbott ID NOW STREP A2) in saliva, compared with a conventional pharyngeal rapid antigen detection test (EXACTO PRO STREPTATEST, lateral flow assay, comparator test), with a composite reference standard of throat culture and group A streptococcus PCR in children with pharyngitis in primary care (i.e., 27 primary care pediatricians or general practitioners). To ensure group A streptococcus is not missed, the salivary rapid nucleic acid test requires a minimally acceptable value of sensitivity (primary outcome) set at 80%. Assuming 35% of participants will have group A streptococcus, we will recruit 800 consecutive children with pharyngitis. Secondary outcomes will include difference in sensitivity between the pharyngeal rapid antigen detection test and the salivary rapid nucleic acid test; variability in sensitivity and specificity of the salivary rapid nucleic acid test with the level of McIsaac score; time to obtain the result of the salivary rapid nucleic acid test; patient, physician, and parents satisfaction; and barriers and facilitators to using rapid tests for group A streptococcus in primary care. Ethics and dissemination Approved by the Institutional Review Board “Comité de protection des personnes Ile de France I” (no. 2022-A00085-38). Results will be presented at international meetings and disseminated in peer-reviewed journals. Trial registration number ClinicalTrials.gov: NCT05521568.

Acute pharyngitis can cause sore throat. This multicentre, active-controlled, randomised, open-label, and parallel-group study, conducted according to the German Medical Devices Act, compared the effectiveness and tolerability of ERS09 mouth and throat spray with a well-established device for the treatment of sore throat caused by acute pharyngitis and dry cough. Patients were randomised 1:1 into ERS09/comparator groups (EMSER® Sore Throat Spray) for 7 ± 2 days. Patients and investigators reported effectiveness (change in total symptom score [TSS]) and safety endpoints (incidence of adverse events [AEs]; adverse device effects [ADEs]). A total of 186 patients were included (ERS09: n = 92; comparator: n = 94). The baseline-adjusted mean TSS over 7 days was −90.14 and −74.91 in the ERS09 and comparator groups, respectively (p < 0.05). The majority of patients reached a 50% reduction in symptoms by day 6 (ERS09 = 78.85; comparator = 75.8%). Most patients reported a soothing effect within five minutes (ERS09 = 82%; comparator = 71%). Improvements in individual symptoms were similar with no significant differences between groups; more patients in the ERS09 group reported an improvement in pharyngeal redness/swelling. Three AEs unrelated to medication, one ADE following ERS09, and no serious AE/ADE were reported. ERS09 was as well tolerated and effective as the established device, showing greater improvement in the management of some symptoms and greater patient preference. [ABSTRACT FROM AUTHOR]

Though more than 80% of acute pharyngitis (AP) cases have a viral etiology, it remains one of the most common causes for the unnecessary prescription of antibiotics (ABs). Half of patients receive antibiotics in general practice. Point-of-Care Tests (POCTs) distinguish between bacterial and viral pharyngitis. The objective of this study was to evaluate the use of POCTs using throat swabs to detect β-Streptococcus pyogenes Group A (strep A) infection among patients with sore throat/acute pharyngitis in primary care practices across Germany. A study was conducted in 1257 primary care practices. Two questionnaires were administered concerning frequency, POCT results and whether antibiotics were prescribed. Of the 1257 physicians, 60% used POCTs. Of these, 25% used a POCT before prescribing an antibiotic, 39% in cases of severe sore throat, 40% in cases of long-lasting pharyngitis and 25% in other cases. In total, 83% considered the adoption of POCTs in everyday practice to be important or very important for the diagnosis of strep A, 90% considered it important or very important for achieving a more sensible use of antibiotics and the prevention of bacterial resistance and 80% considered it important or very important for justifying to patients whether or not an antibiotic is needed. POCT results and information on AB prescriptions were available for 583 patients. Of these, 22.5% tested positive for strep A, and 21.8% were prescribed antibiotics. Our study shows that the use of swab tests in patients with sore throat in primary care practices results in high levels of physician satisfaction and can strongly reduce the misuse of antibiotics in clinical practice. [ABSTRACT FROM AUTHOR]

Antibiotic resistance is closely related to the inappropriate use of antibiotics, namely the indication, dose, frequency, and duration of use. Permenkes No. 5 of 2014 states that acute pharyngitis is given antibiotic therapy if it meets the diagnostic criteria using the center criteria, but this criterion is difficult to apply because doctors take longer to diagnose. Previous research at the Klungkung I Primary Health Center used diagnosis utilizing a swab test. It was found that 100% of bacterial pharyngitis patients were negative. The strategy of delaying antibiotics for 3 days can prevent antibiotic resistance, but in therapy, without antibiotics, it is important to increase the effectiveness of therapy, it is deemed necessary by the researchers to conduct a study to analyze the factors that affect the recovery of patients with acute pharyngitis, which are mainly caused by viruses. Analyzing the factors that affect the recovery of viral pharyngitis patients. The design of the cross-sectional study was through observation of the medical record data of patients who came to the Klungkung Primary Health Center I for 3 months and got diagnostic facilities using the swab test. Patients who got a negative swab test were analyzed for the factors that influenced their recovery. Anti-inflammatory variables, rest, and paracetamol significantly affected the recovery of acute pharyngitis patients (p

Pudilan Xiaoyan Oral Liquid (PDL) is a proprietary Chinese medicinal preparation approved by the State for treating acute pharyngitis in both adults and children (Approval No. Z20030095). It is worth noting that children exhibit unique physiopathological characteristics compared to adults. However, the in vivo regulatory characteristics of PDL in treating acute pharyngitis in children remain incompletely understood. The differential absorption and metabolism characteristics of the main pharmacological components in PDL in young and adult rats were investigated with a view to providing a reference for preclinical data of PDL in medication for children. This study utilized UPLC-Q-TOF-MS to investigate the pharmacodynamic material basis of PDL. The focus was on the gastrointestinal digestion and absorption characteristics of organic acid components in PDL (PDL-OAC), known as the primary pharmacodynamic components in this formulation. The research combined in vitro dynamic simulation and a Quadruple single-pass intestinal perfusion model to examine these characteristics. The permeability properties of PDL-OAC were evaluated using an artificial parallel membrane model. Additionally, an acute pharyngitis model was established to evaluate the histopathological condition of the pharynx in young rats using H&E staining. The levels of IL-1 β , TNF- α , IL-6, and IL-10 in blood and pharyngeal tissue homogenates of young rats were quantified using ELISA kits. A total of 91 components were identified in PDL, including 33 organic acids, 24 flavonoids, 14 alkaloids, 5 terpenoids and coumarins, 3 sugars, and 12 amino acids. The PDL-OAC exhibited a significant reduction in IL-1 β , TNF- α , IL-6, and IL-10 levels in the pharyngeal tissues of young rats with acute pharyngitis. Results from dynamic simulation studies of gastrointestinal fluids revealed that the PDL-OAC (Specifically chlorogenic acid (CGA), gallic acid (GA), chicoric acid (CRA), and caffeic acid (CA)) were effectively stabilized in the gastrointestinal fluids of both children and adults in vitro. Young rats, characterized by thinner intestinal walls and higher permeability, efficiently absorbed the four organic acids across the entire intestinal segment. The absorption of CGA, GA, and CRA followed a concentration-dependent pattern, with CGA and GA absorption being influenced by exocytosis. The efficacy of the PDL-OAC in treating acute pharyngitis was demonstrated in young rats. The absorption rate of these components was observed to be faster in young rats compared to adult rats, underscoring the need for dedicated studies on the drug's usage in children. This research provides valuable insights for the appropriate clinical use of PDL in pediatric patients. [Display omitted] [ABSTRACT FROM AUTHOR]

• Kegan Liyan oral liquid improved the recovery rate of acute pharyngitis patients. • Kegan Liyan oral liquid shortened time to sore throat recovery in acute pharyngitis. • The use of Kegan Liyan oral liquid was safe and tolerated. • Kegan Liyan oral liquid may provide new options for treating acute pharyngitis. Alleviating the sore throat caused by acute pharyngitis is a primary patient concern. However, antibiotics are not commonly recommended drugs, and abuse can lead to serious consequences such as drug resistance. Therefore, seeking alternative treatments is necessary. To investigate the efficacy and safety of Kegan Liyan (KGLY) oral liquid for patients with acute pharyngitis. Randomized, double-blinded, placebo-controlled, multi-center study. Participants from 17 hospitals were randomly assigned 1:1 to receive KGLY oral liquid or placebo for five days. Assessments occurred at baseline, day 3, and day 6. The primary outcome was the recovery rate. Secondary outcomes included sore throat and cough visual analogue scale (VAS), the area under the curve (AUC) of sore throat VAS, time to sore throat relief and recovery, proportion of participants with sore throat relief and recovery, traditional Chinese medicine (TCM) syndrome score, single TCM manifestation score and use of acetaminophen. Involving 239 participants (120 in KGLY and 119 in placebo group), the study found a significantly higher recovery rate on day 6 in the KGLY group (between-group difference, 27.20 % [15.00 % to 39.40 %], p < 0.001). On day 3 and 6, the KGLY group showed significantly larger reductions in sore throat (–3.02 vs –2.37, p = 0.001; –4.66 vs –3.64, p < 0.001) and cough VAS scores (–1.55 vs –1.05, p = 0.004; –2.28 vs –1.56, p < 0.001) from baseline. KGLY oral liquid lowered the AUC of sore throat VAS score (–2.33 [–4.10 to –0.56], p = 0.011), shortened time to sore throat recovery (hazard ratio, 0.42 [0.30 to 0.59], p < 0.001), increased sore throat recovery rate at day 6 (75.00 % vs 42.86 %, p < 0.001), decreased the TCM syndrome score (–2.03 [–2.69 to –1.37], p < 0.001), and improved individual TCM symptoms compared to placebo. No significant differences between the groups in acetaminophen usage. KGLY oral liquid was safe and tolerated. KGLY oral liquid may be a beneficial and safe alternative treatment for acute pharyngitis, which can alleviate symptoms such as sore throat, swollen throat, cough, and phlegm production. [Display omitted] [ABSTRACT FROM AUTHOR]

Jiegeng decoction (JGD), consisting of Glycyrrhizae Radix et Rhizoma and Platycodonis Radix at the ratio of 2:1, is a classical Chinese medicine prescription firstly recorded in "Treatise on Febrile Diseases". JGD has been extensively utilized to treat sore throat and lung diseases for thousands of years in China. However, the pharmacological effect and mechanism of JGD on acute pharyngitis (AP) remain unclear. Our research aimed to reveal the pharmacological effect of JGD on AP and its potential mechanisms. The chemical components of JGD were analyzed based on the UPLC-MS analysis. The anti-inflammatory effect of JGD was evaluated by NO production using the Griess assay in RAW 264.7 cells. The mRNA expression of iNOS, IL-1β, IL-10, TNF-α, IL-6 and MCP-1 was determined by qRT-PCR in vitro. A 15% ammonia-induced AP model was established. The histopathology, the inflammatory cytokines IL-6 and MCP-1 in serum and the apoptosis-related genes caspease-8 and caspease-3 were determined by H&E staining, ELISA and qRT-PCR, respectively. The expression levels of p-p65, p65, p-JNK, JNK, p-p38, p38, p-ERK1/2, ERK1/2, and COX2 were measured through western blotting. Nine compounds, including liquiritin, liquiritin apiosde, liquiritigenin, platycodin D, platycoside A, licorice saponin J2, licorice saponin G2, glycyrrhizic acid, and licochalcone A, were identified. JGD significantly inhibited NO production and regulated the mRNA expression levels of cytokines in LPS-stimulated RAW 264.7 cells. The results of in vivo experiments confirmed that JGD ameliorated AP through improving the pathological state of pharyngeal tissue, decreasing the serum levels of IL-6 and MCP-1 and preventing the tissue mRNA expression of caspease-8 and caspease-3. Furthermore, JGD also inhibited the NF-κB and MAPK pathways in the AP model. This study suggested that JGD could alleviate AP through its anti-inflammation via NF-κB and MAPK pathways, which supported the traditional application of JGD for the treatment of throat diseases. [Display omitted] • JGD arrested NO production of LPS-induced RAW 264.7 cells. • JGD altered the mRNA expression level of inflammatory cytokines in LPS-induced RAW 264.7 cells. • JGD ameliorated ammonia-induced acute pharyngitis in vivo at the doses of 0.84 g/kg and 3.36 g/kg. • JGD inhibited pharyngitis by downregulating NF-κB and MAPK signaling pathways. [ABSTRACT FROM AUTHOR]

Though more than 80% of acute pharyngitis (AP) cases have a viral etiology, it remains one of the most common causes for the unnecessary prescription of antibiotics (ABs). Half of patients receive antibiotics in general practice. Point-of-Care Tests (POCTs) distinguish between bacterial and viral pharyngitis. The objective of this study was to evaluate the use of POCTs using throat swabs to detect β-Streptococcus pyogenes Group A (strep A) infection among patients with sore throat/acute pharyngitis in primary care practices across Germany. A study was conducted in 1257 primary care practices. Two questionnaires were administered concerning frequency, POCT results and whether antibiotics were prescribed. Of the 1257 physicians, 60% used POCTs. Of these, 25% used a POCT before prescribing an antibiotic, 39% in cases of severe sore throat, 40% in cases of long-lasting pharyngitis and 25% in other cases. In total, 83% considered the adoption of POCTs in everyday practice to be important or very important for the diagnosis of strep A, 90% considered it important or very important for achieving a more sensible use of antibiotics and the prevention of bacterial resistance and 80% considered it important or very important for justifying to patients whether or not an antibiotic is needed. POCT results and information on AB prescriptions were available for 583 patients. Of these, 22.5% tested positive for strep A, and 21.8% were prescribed antibiotics. Our study shows that the use of swab tests in patients with sore throat in primary care practices results in high levels of physician satisfaction and can strongly reduce the misuse of antibiotics in clinical practice.

Introduction: Purpose of the study is to manage recurrent pharyngitis (Ekvrindamukharoga) because antibiotic resistance issue is a big concern as there is no permanent management in conventional medicine. Main Clinical Finding & Diagnosis: The present case was diagnosed with viral pharyngitis on basis of fever, sore throat &lymphocytosis. Interventions: TalishadiChurna, Mrityunjaya rasa, Laxmivilasa rasa & Tankana were administered for 3 days and subsequently Vamana (~induced therapeutic vomiting) was performed to prevent recurrence. Outcome: Major improvement recorded in oral temperature, color (beefy red to light pink), etc., after the intervention. Throat pain (from 5 point to 1) and swelling (from 2 to 1) after 2 h and were relieved completely after 3 days. Conclusion: This case study reports effective management of antimicrobial-resistant acute pharyngitis with stand-alone Ayurvedic therapy. Non-relapse of symptoms after Vamana during the follow-up period (6 months) emphasizes the effective secondary prevention achieved with Ayurveda.

Chuanhuang Qingre capsule (CHQR) is composed of Andrographis paniculata and solidago virgaurea, mainly used for treating acute respiratory infection, acute tonsillitis and acute pharyngitis. However, the mechanism of CHQR in treating pharyngitis is still unclear. In this study, UHPLC‐Q‐Orbitrap HRMS technology was used to identify the chemical constituents in CHQR. Network pharmacology combined with a molecular docking approach was used to screen for possible mechanisms to predict CHQR for treating acute pharyngitis. Finally, a rat model of acute pharyngitis was used to confirm the mechanism of CHQR in treating acute pharyngitis.The results showed that UHPLC‐Q‐Orbitrap HRMS identified 68 compounds. Network analysis showed that TP53, AKT1, TNF, IL6 and EGFR were the key targets. The results of molecular docking showed reasonable binding force. The experimental results showed that CHQR could reduce inflammatory cell infiltration and improve pharyngitis symptoms in rats with acute pharyngitis. Elisa results showed that the levels of PGE2, IL‐1β, TNF‐α and IL‐6 in serum decreased. It is suggested that CHQR can prevent and treat acute pharyngitis, mainly by inhibiting the TNF pathway and reducing of inflammatory cytokines levels, which can provide scientific references for clinical research. [ABSTRACT FROM AUTHOR]

The paper explores the thoughts and manipulations of tuina at "Tianyou (TE 16) and five regions" for the treatment of acute pharyngitis based on "Tianyou (TE 16) and five regions" in Huangdi Neijing (Yellow Emperor's Inner Classic). "Tianyou (TE 16) and five regions" refer to the special acupoints of yang meridians, mostly located at the neck region. It is the "window" of the head and neck, acting on dispersing wind and regulating qi and blood by opening the "window". Acute pharyngitis is caused by the invasion of exogenous wind and heat to the throat or by re-attack of exogenous factors and heat accumulation in the lung and stomach. Pathogenic wind and heat is the chief causative factor. Based on the theory and location of "Tianyou (TE 16) and five regions", the manipulations of tuina , i.e. point-pressing, plucking and smoothing, are operated to open " huyou " (door and window) of the head and face, combined by bleeding at the ear apex so that the path is opened for pathogen elimination. As a result, the pathogenic wind and heat are dispelled, qi movement is promoted and the throat is benefited.

Abstract Background Streptococcus pyogenes (S. pyogenes) is a Gram positive bacterium which is a leading cause of pharyngitis, skin and soft tissue infection and post streptococcal syndromes. Due to lack of β-lactamase enzyme production, it was considered universally susceptible to penicillin group and later generation of β-lactam antibiotics. As such, empirical treatment was common which might leads to development of antibiotics resistance. Therefore, the aims of this study were to determine the prevalence, antibiotics susceptibility profile; and associated factors of S. pyogenes among pediatric patients with acute pharyngitis in Felege Hiwot Comprehensive Specialized Hospital (FHCSH), Northwest Ethiopia. Methods Hospital based cross-sectional study was carried out on 154 pediatric patients, whose age ranged from 0 to 18 years old using consecutive convenient sampling technique from 1st February to 19th June 2020 at FHCSH. S. pyogenes were identified by throat swab culture on 5% sheep blood agar with an overnight incubation at 37 °C in candle jar containing 5% CO2. Gram stain, catalase test and bacitracin test were used to identify S. pyogenes. Then,the data were entered into EpiData version 3.1 and analyzed by SPSS version 20 software. Finally, stepwise, bivariable and multivariable logistic regressions were carried out for identifyying factors having significant ssociation (p

Acute pharyngitis is a common disease among the adult population. The most common causative agents of acute inflammatory diseases of the pharynx are p-hemolytic streptococci. Oromucous sprays, which are used in this case for treatment, are a special dosage form that ensures the spraying of particles of the active substance and their adhesion to the mucous membrane of the oral cavity and pharynx. The purpose of the study: to determine the therapeutic effect and the level of bacteriological colonization of the drug "Lorosan" for the treatment of acute pharyngitis. Materials and methods: 32 patients, aged from 20 to 27 years, with symptoms corresponding to the nosological form of acute pharyngitis were examined. Clinical examination of patients was carried out at the beginning of the disease and one week after treatment with Lorosan. The clinical effectiveness of the drug was determined by analyzing changes in complaints and the condition of the mucous membrane of the oropharynx. Results: After using the drug "Lorosan" for 7 days, all patients noted a decrease in pain in the throat, a significant decrease in the sensation of a foreign object in the throat and the number of secretions, normalization of the general condition and full recovery of the voice. The number of caseous tonsillitis in the tonsillar lacunae decreased, and the unpleasant smell from the mouth disappeared. The obtained results of the microbiological study of the biomaterial taken after 7 days of treatment with the drug "Lorosan" showed a sharp decrease in the number of microorganisms and the level of their spread of the posterior pharynx. Thus, the new natural oromucous spray from sunflower is an effective drug in the monotherapy of acute pharyngitis in adults, as it allows to significantly reduce the clinical symptoms of the disease and significantly reduce the bacterial colonization of the oropharynx by the causative agents of inflammatory processes. [ABSTRACT FROM AUTHOR]

The larynx is the first part of the respiratory and digestive tract and it performs vital functions. The air stream, passing through the throat and coming into contact with its mucous membrane, is moistened, warmed up and purified. Due to the anatomical structure of the mouth cavity and pharynx, it creates conditions for entry, presence and inactivation of microorganisms, viruses and fungi. Under normal conditions, due to effective protective mechanisms (mucociliary and immune), pathogens are trapped in the upper respiratory tract while the lower sections remain «clean». Acute pharyngitis is a widespread, polyetiological disease of the upper respiratory tract. There are quite a few preconditions for its development. A favorable background for local inflammation is the reduction of specific and non-specific protection factors, which may be observed in the existing chronic inflammation and worsened in diabetes mellitus and metabolic syndrome, with prolonged use of cytostatics and/or glucocorticosteroids and many other immunocompromised conditions. Due to the prevalence of pharyngitis, the development of effective screening and treatment methods is particularly relevant. Given the localized nature of inflammatory process in the pharynx and the possibility of side effects, general anti-inflammatory drugs are used less and less frequently, and local non-steroidal anti-inflammatory drugs are increasingly drawing the attention of physicians. The article discusses the possibilities and effectiveness of the medication based on benzidamine hydrochloride in treating pharyngitis of diverse etiology. The article presents the studies of foreign scientists, as well as dosages and peculiarities of the medication application. Treatment of acute tonsillipharyngitis with local non-steroidal anti-inflammatory drugs is commonly accepted and widely used in the practice of pediatricians, therapists and otorhinolaryngologists and allows to achieve rapid relief of the patient’s condition.

Abstract Introduction The aim of this study was to evaluate the efficacy and safety of a new hard-boiled lozenge formulation containing ambroxol 20 mg versus placebo for the relief of sore throat in patients with acute pharyngitis. Methods This was a phase 3, randomized, double-blind, placebo-controlled, parallel-group multicenter trial conducted between June and September 2018 in South Africa. Patients with a diagnosis of acute pharyngitis, onset ≤ 72 h, and sore throat pain of at least moderate intensity were randomized to receive either ambroxol 20 mg or placebo hard-boiled lozenges. The primary efficacy endpoint was the normalized time-weighted sum of pain intensity differences (SPID) from baseline over 3 h following administration of the first lozenge (SPIDnorm,0–3h). Secondary efficacy endpoints included SPID 24 h after the first lozenge intake (SPIDnorm,0–24h) and patient assessment of efficacy at 3 and 24 h after the first lozenge. Results Of 422 patients from 11 centers, 390 were randomized to one of the two treatment groups (n = 196, ambroxol; n = 194, placebo) and 388 were analyzed (modified intention-to-treat). The mean ± standard deviation SPIDnorm,0–3h values were −0.386 (0.259) and −0.366 (0.243) in the ambroxol and placebo groups, respectively, and the adjusted mean ± standard error SPIDnorm0–3h difference between ambroxol and placebo was −0.020 (0.025) (p = 0.443). Comparable results between treatment groups were also found for SPIDnorm,0–24h and patient assessment of efficacy at 3 and 24 h after the first lozenge. The incidence of treatment-emergent adverse events (TEAEs) was similar between treatment groups (11.7% for ambroxol versus 9.3% for placebo). Conclusion Although marked pain relief was observed over the first 3 h of treatment, superiority of ambroxol 20 mg hard-boiled lozenges versus placebo was not demonstrated in this study. Trial Registration NCT03583658. Funding Sanofi-Aventis Group.

Abstract Background The national guideline for sore throat, endorsed by the Danish Society of General Medicine, recommends the use of the modified Centor score and streptococcal rapid antigen detection test to guide diagnosis and treatment of sore throat. The aim was to investigate Danish general practitioners (GPs) routine management of sore throat patients with a focus on the modalities used and adherence to the guideline. Methods A cross-sectional study. GPs in the Central Denmark Region answered an online questionnaire in October 2017. The main outcome measure was modalities used in the management of sore throat patients. Results In total, 266 of 500 (53%) GPs answered the survey. Ten percent of participants were adherent or almost adherent to the guideline, while 82% of GPs added one or more extra modalities (general clinical assessment (67%), biochemical parameters (48%), and throat swabs for bacterial culture (18%)) to differentiate viral and bacterial etiology. Sixty-five percent of participants used the Centor Score or modified Centor Score, 96% of GPs used a streptococcal rapid antigen detection test, and all GPs chose narrow-spectrum penicillin as the first-line antibiotic. The most common reasons for non-adherence to the guideline were greater confidence in the clinical assessment (39%), time pressure (33%), and difficulty recalling the guideline (19%). Conclusion Danish GPs rarely adhere to the recommended sore throat management guideline, but use various combinations of different modalities in the assessment of bacterial infection. This practice may increase antibiotic prescription rates.

Background: Acute rheumatic fever (ARF) affects millions of children in the third world countries like India. The diagnosis of rheumatic fever is based on the Jones criteria with serological titers, antistreptolysin O titer (ASO), and anti-deoxyribonucleic B (ADB), taken as evidence of recent streptococci infection. There is a lack of recent data available on ASO and ADB titers in children from the Delhi/NCR and thus adequate geographical area-specific cutoffs for the region are not available. Aims and Objectives: The aim of this study is to determine and compare the ASO and ADB antibody titers in children with acute pharyngitis, ARF, rheumatic heart disease (RHD), and in healthy children of the Delhi/NCR region. Materials and Methods: Twenty-six cases of ARF, 51 cases of RHD, 50 cases of acute pharyngitis, and 84 healthy normal children were included in the study. A single ASO and ADB titer measurement was done in these children. Results: The ASO titers was raised in acute pharyngitis – 303 IU/ml (interquartile range [IQR], 142–520 IU/ml) and ARF – 347.5 IU/ml (IQR, 125–686 IU/ml) children in comparison to healthy controls – 163.5 IU/ml (IQR, 133–246.5 IU/ml) and RHD patients – 163 IU/ml (IQR, 98.250–324.500). The ADB titers were highest in ARF patients – 570.5 IU/ml (IQR, 276–922 IU/ml) followed with RHD – 205 IU/ml (IQR, 113.6–456.5), healthy controls – 78.25 IU/ml (IQR, 53.39–128.15 IU/ml), and acute pharyngitis – 75.12 IU/ml (IQR, 64.5–136 IU/ml). The upper limit of normal (ULN) values of ASO and ADB computed from normal healthy children were 262.4 IU/ml and 134.44 IU/ml, respectively, and these can be used as cutoff values for recent streptococcal infection in this geographical area. Conclusions: The median ASO titers in acute pharyngitis group and ARF were significantly raised compared to that of the control group. The ADB titers were raised in ARF and RHD patients albeit the levels were higher in ARF patients. The derived ULN values can be used as cutoff reference.

Background: Streptococcus pyogenes (S. pyogenes) is a Gram positive bacterium which is a leading cause of pharyngitis, skin and soft tissue infection and post streptococcal syndromes. Due to lack of β-lactamase enzyme production, it was considered universally susceptible to penicillin group and later generation of β-lactam antibiotics. As such, empirical treatment was common which might leads to development of antibiotics resistance. Therefore, the aims of this study were to determine the prevalence, antibiotics susceptibility profile; and associated factors of S. pyogenes among pediatric patients with acute pharyngitis in Felege Hiwot Comprehensive Specialized Hospital (FHCSH), Northwest Ethiopia. Methods: Hospital based cross-sectional study was carried out on 154 pediatric patients, whose age ranged from 0 to 18 years old using consecutive convenient sampling technique from 1st February to 19th June 2020 at FHCSH. S. pyogenes were identified by throat swab culture on 5% sheep blood agar with an overnight incubation at 37 °C in candle jar containing 5% CO2. Gram stain, catalase test and bacitracin test were used to identify S. pyogenes. Then,the data were entered into EpiData version 3.1 and analyzed by SPSS version 20 software. Finally, stepwise, bivariable and multivariable logistic regressions were carried out for identifyying factors having significant ssociation (p<0.05) with acute pharyngitis. Results: From the total throat swabs, 14 (9.1%) with (95% CI; 4.5–14.3) were culture positive for S. pyogenes. From these, all isolates were sensitive to penicillin and ampicillin. On the otherhand, 4 (35.7%), 4 (35.5%), 3 (21.4%), 2 (14.3%), 1 (7.1%), 7 (50.0%) and 1 (7.1%) isolates were resistant for ceftriaxone, vancomycin, erythromycin, tetracycline, chloramphenicol, clindamycin and levofloxacin, respectively. The presence of any smoker in home showed significant association with S. pyogenes acute pharyngitis. Furthermore, having tender lymphadenopathy and recurrence were clinical predictors for S. pyogenes acute pharyngitis (P < 0.05). Conclusion: The prevalence of S. pyogenes was guaged at 9.1% which is considered as low prevalence. All S. pyogenes isolats remain sensitive to penicillin. However, resistance was reported to clindamycin 7 (50.0%), ceftriaxone 5 (35.7%) and erythromycin 3 (21.4%). The current practice of giving erythromycin, clindamycin instead of penicillin and ampicillin is againest the microbiology result. Therefore, current empirical treatment of acute pharyngitis shall take in to account the current evidences. Continuous surveillance of antibiotics resistance pattern of S. pyogenes for acute pharyngitis must be strengthen to improve the use of antibiotics in hospitals. [ABSTRACT FROM AUTHOR]

This is a 12-part series on the most commonly billed diagnoses in primary care. The article discusses the pathophysiologic processes of acute pharyngitis as well as the clinical manifestations and treatments and how they are linked to disease pathogenesis. [ABSTRACT FROM AUTHOR]

Objective: To assess whether web-based public inquiries into pharyngitis-related search terms follow annual incidence peaks of acute pharyngitis in various countries from both hemispheres. Methods: Google Trends (GT) was utilized for systematic acquisition of pharyngitis-related search terms (sore throat, cough, fever, cold). Six countries from both hemispheres including four English (United Kingdom, United States, Canada, and Australia) and two non-English speaking countries (Austria and Germany) were selected for further analysis. Time series data on relative search interest for pharyngitis-related search terms, covering a timeframe between 2004 and 2019 were extracted. Following reliability analysis using the intra-class correlation coefficient, the cosinor time series analysis was utilized to determine annual peaks in public-inquiries. Results: The extracted datasets of GT proved to be highly reliable with correlation coefficients ranging from 0.83 to 1.0. Graphical visualization showed annual seasonal peaks for pharyngitis-related search terms in all included countries. The cosinor time series analysis revealed these peaks to be statistically significant during winter months (all p < 0.001). Conclusion: Our study revealed seasonal variations for pharyngitis-related terms which corresponded to winter incidence peaks of acute pharyngitis. These results highlight the need for easily accessible information on diagnosis, therapy, and red-flag symptoms for this common disease. Accurately informed patients might contribute to a reduction of unnecessary clinic visits and potentially cutback the futile antibiotic overuse. [ABSTRACT FROM AUTHOR]

Introduction: The causative agents of acute tonsillopharyngitis are viruses and bacterial flora. Treatment of acute pharyngitis is mainly local, which includes aerosols with antiseptics. Aim: Study of antimicrobial action of "Apicold oral spray" on clinical isolates of microorganisms Streptococcus pyogenes, Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis and Candida albicans isolated from patients' oropharynx in patients. Material and methods: The effect of Apicold Oral Spray (manufactured by APIPHARMA doo) on clinical isolates of Streptococcus pyogenes, Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis, and Candida albicans in Ukrainian patients was studied. Antimicrobial activity was assessed after 5, 10 and 20 minutes of action of one dose of "Apicold oral spray" on microorganisms. Bactericidal and fungicidal action (inhibition of cell growth of microorganisms) is expressed as a percentage according to the control. Results and discussion: Apicold Oral Spray has a 100% antimicrobial effect after 5 minutes on clinical isolates of Streptococcus pyogenes, Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis and Candida albicans (complete growth inhibition of all 5 clinical isolates after 20 minutes). Conclusion: "Apicold oral spray" has a high antimicrobial effect on clinical isolates of Streptococcus pyogenes, Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis and Candida albicans, which is confirmed by 100% inhibition of the growth of all bacteria after 5 minutes. [ABSTRACT FROM AUTHOR]

We report a case of phlegmonous gastritis that followed an episode of acute pharyngitis. A 21-year-old man visited our emergency room because of intense epigastric pain. Fourteen days before the visit, he had symptoms of a sore throat and high fever. He was diagnosed with acute pharyngitis and treated with antibiotics. Although the symptoms of acute pharyngitis were relieved, epigastric pain began 5 days before the emergency visit. Computed tomography showed diffuse gastric wall thickening, and emergent esophagogastroduodenoscopy revealed diffusely spreading hyperemic mucosa with multiple erosions. He was admitted with a diagnosis of acute phlegmonous gastritis and was treated with antibiotics. The antibiotic treatment was effective and resulted in resolution of his clinical symptoms and normalized C-reactive protein concentrations. On hospital day 29, he was discharged. However, he was re-admitted because of recurrence of phlegmonous gastritis 5 days after discharge and 15 days after finishing the antibiotics. Cultures of gastric biopsies and juice were both positive for Streptococcus constellatus/milleri. Antibiotic treatment was effective, and he recovered without recurrence. A possible association between upper respiratory infections and subsequent phlegmonous gastritis has been reported, and this case supports causality. However, further studies are needed to evaluate causality and pathogenesis. [ABSTRACT FROM AUTHOR]

Background: Antibiotic treatment guidelines for common infectious diseases enable proper diagnosis and treatment and avoid unnecessary antibiotic treatment, preventing both financial expenditure and antimicrobial resistance to antibiotics. Methods: The aim of our study was to investigate whether community physicians referring patients to the medical centre and whether emergency department (ED) physicians diagnose and treat acute pharyngitis according to these guidelines. We conducted a retrospective study. Data were collected on 99 patients admitted with the diagnosis of acute pharyngitis. The patients were admitted to the medical centre between 2015 and 2014. The physicians' adherence to antibiotic guidelines for indication, type and duration of treatment for acute pharyngitis was examined. Results: The adherence of community physicians regarding the indication for antibiotic treatment was low (16%). The adherence of community and ED physicians regarding the type of treatment was high (96% and 99%, respectively). The adherence of ED physicians regarding the duration of treatment was higher than the adherence among community physicians (58% and 13.3%, respectively, Wilcoxon signed‐rank test, P <.001). Interns tended to adhere to the guidelines more than seniors (36.4% versus 12.0%, respectively, Fisher's exact test, P =.07). Conclusions: There is a lack of compliance with the guidelines among community physicians regarding the diagnosis and antibiotic treatment of acute pharyngitis, which is characterized by excessive antibiotic treatment. Therefore, ways to increase awareness and adherence to clinical guidelines, and to allow the conditions in the clinics to fulfil the guidelines should be investigated. [ABSTRACT FROM AUTHOR]

Background: Pharyngitis is one of the most frequently faced pediatric problems with serious complications in primary care. Objective(s): To compare between Integrated Management of Childhood Illness (IMCI) guidelines and traditional management concerning diagnosis and antibiotic prescription for acute pharyngitis in children less than 5 years, as well as to determine validity of IMCI guidelines in diagnosis of acute pharyngitis by comparing their results to throat culture as a golden standard. Methods: A comparative cross-sectional study was conducted in one primary health care center and one unit where IMCI guidelines were implemented; as well as one center and one unit where traditional management of acute pharyngitis was implemented in Zagazig district, on 343 children under five years complaining of sore throat or difficult feeding. About 86 children were randomly selected from each health facility during the period of first of January until end of June 2017. Doctor’s clinical diagnosis and antibiotic prescription were reported for all children, while throat swabs were taken from children managed according to IMCI guidelines for bacterial culture. Results: According to IMCI, only 11 % of children were diagnosed as bacterial pharyngitis, antibiotic prescription was significantly lower among those managed according to IMCI compared to traditional methods (11% & 96.5% respectively, P

Today, one of the most frequent causes for visiting paediatricians, general practitioners, ENT specialists are infectious inflammatory diseases of the pharynx [1]. Acute pharyngitis is a common manifestation of various acute respiratory viral and bacterial infections [2]. The drugs to be used for the local treatment of pharyngitis should meet the following requirements: have a broad spectrum of antibacterial activity, no toxic or irritating effects on the mucous membrane, low absorption rate and low allergenicity.

Introduction: Acute pharyngitis is an inflammatory disease of the throat (pharynx) that occurs suddenly and often occurs in children. The physical house environment is suspected to be a risk factor for acute pharyngitis in toddlers. This study aimed to determine the dominant risk factors of acute pharyngitis in toddlers in the sub-district of Sangkrah Public Health Care, Surakarta, Indonesia. Methods: A case-control study conducted in children aged 12 to 59 months who suffered from acute pharyngitis disease based on doctors' diagnosed in the Sangkrah District Public Health Centre in December 2016 until March 2017. The diagnosis of acute pharyngitis cases using McIsaac scores ≥4. The number of cases was 55 toddlers, compared with 55 controls to determine risk factors for the house environment against pharyngitis. The data were collected by questionnaire and observation checklist. Data analysis was done using SPSS version 20. Results: A total of 110 respondents were recruited into this study. The mean age of toddler in case and control group was 34.87 ± 12.99 months and 32.07 ± 14.14 months, respectively. Multiple logistic regression analysis showed that house ventilation (p = 0.009; aOR 3.273; 95% CI = 1.340-7.995) and floor condition (p = 0.022; aOR 3.053; 95% CI = 1.172-7.95) that contributed to acute pharyngitis at toddler. Conclusion: Our study reported that inadequate ventilation and not-waterproof floor condition were physical house environment risk factors the determinant factors for the occurrence of acute pharyngitis at toddlers. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate the efficacy and safety of a new hard-boiled lozenge formulation containing ambroxol 20 mg versus placebo for the relief of sore throat in patients with acute pharyngitis. Methods: This was a phase 3, randomized, double-blind, placebo-controlled, parallel-group multicenter trial conducted between June and September 2018 in South Africa. Patients with a diagnosis of acute pharyngitis, onset ≤ 72 h, and sore throat pain of at least moderate intensity were randomized to receive either ambroxol 20 mg or placebo hard-boiled lozenges. The primary efficacy endpoint was the normalized time-weighted sum of pain intensity differences (SPID) from baseline over 3 h following administration of the first lozenge (SPIDnorm,0–3h). Secondary efficacy endpoints included SPID 24 h after the first lozenge intake (SPIDnorm,0–24h) and patient assessment of efficacy at 3 and 24 h after the first lozenge. Results: Of 422 patients from 11 centers, 390 were randomized to one of the two treatment groups (n = 196, ambroxol; n = 194, placebo) and 388 were analyzed (modified intention-to-treat). The mean ± standard deviation SPIDnorm,0–3h values were −0.386 (0.259) and −0.366 (0.243) in the ambroxol and placebo groups, respectively, and the adjusted mean ± standard error SPIDnorm0–3h difference between ambroxol and placebo was −0.020 (0.025) (p = 0.443). Comparable results between treatment groups were also found for SPIDnorm,0–24h and patient assessment of efficacy at 3 and 24 h after the first lozenge. The incidence of treatment-emergent adverse events (TEAEs) was similar between treatment groups (11.7% for ambroxol versus 9.3% for placebo). Conclusion: Although marked pain relief was observed over the first 3 h of treatment, superiority of ambroxol 20 mg hard-boiled lozenges versus placebo was not demonstrated in this study. Trial Registration: NCT03583658. Funding: Sanofi-Aventis Group. [ABSTRACT FROM AUTHOR]

Hosta plantaginea (Lam.) Aschers flower is a famous Mongolian folk medicine in China and has a therapeutic effect on acute pharyngitis (AP). However, the effect and potential mechanism of H. plantaginea flower on AP have not been fully elucidated. The present work aimed to evaluate the effects and mechanisms of the crude extract of H. plantaginea flowers (HP) and its four fractions of petroleum ether fraction (HPA), ethyl acetate fraction (HPB), n-butanol fraction (HPC), and water residue (HPD) against AP in rats. A 15% ammonia-induced AP rat model in rats was established. Therapeutic effects of HP and HPA∼D in model rats were evaluated based on body weight, histopathological analysis, and inflammatory parameters, including tumor necrosis factor α (TNF-α), prostaglandin E2 (PGE2), interleukin 1β (IL-1β), and IL-6. The protein expression of nuclear factor kappa-B p65 (NF-κB p65), inhibitor of NF-κB alpha (IκBα), c-Jun N-terminal kinases (JNK), mitogen-activated protein kinase (MAPK) p38, extracellular signal-regulated kinase (Erk), just another kinase 1 (JAK1), signal transducer and activator of transcription 3 (STAT3), phosphoinositide 3-kinase (PI3K), and protein kinase B (Akt) were detected by a Western blotting assay. HP, HPB, and HPC treatments markedly alleviated AP in rats by increasing body weight and improving pathological damages in pharyngeal tissues. In addition, HP, HPB, and HPC treatments significantly inhibited inflammation, including decreasing the levels of TNF-α, PGE2, IL-1β, and IL-6, and suppressing phosphorylated protein expression of p65, IκBα, JNK, p38, Erk, JAK1, STAT3, PI3K, and Akt in pharyngeal tissues of rats. Collectively, HP, HPB, and HPC can attenuate pharynx injury in rats by suppressing inflammation via inhibition of NF-κB, MAPKs, JAK-STAT, and PI3K-Akt pathways, which supports the traditional use of H. plantaginea flowers. [Display omitted] • For the first time, the anti-AP effect and mechanism of Hosta plantaginea were explored in-depth. • Hosta plantaginea flower showed a significant anti-AP effect in rats. • HPB and HPC were the main active fractions of H. plantaginea flower. • HPB and HPC fractions showed anti-AP effects through inhibition of NF-κB, MAPKs, JAK-STAT, and PI3K-Akt pathways. [ABSTRACT FROM AUTHOR]

The article is devoted to acute respiratory viral infections (ARVI) in children. ARVI take one of the leading places in a childhood morbidity structure. The article provides an overview of the clinical guidelines developed and approved by the professional association «Union of Pediatricians of Russia» for acute respiratory infections in children. These guidelines summarize the experience of the leading world and domestic specialists, contain scientific and practical data that correspond to the most relevant trends in the management of children with this pathology. The authors present modern information on the etiology, pathogenesis, classification, clinical findings and differential diagnosis of various nosological forms of acute respiratory tract infections in the pediatric population. The general (strategic) principles of drug-free and drug treatment are discussed in detail.

This study systematically combed the existing evidence of Houyanqing Oral Liquid in the treatment of acute pharyngitis from the &quot;6+1&quot; dimensions of safety, effectiveness, economy, innovation, suitability, accessibility, and characteristics of traditional Chinese medicine(TCM) and carried out qualitative and quantitative analysis of the data from each dimension. The multi-criteria decision analysis(MCDA) model and CSC v2.0 were used to evaluate the clinical value of this drug, so as to provide evidence for the selection of essential drugs in the department of otolaryngology and for medical and health decision-making. The dimensions are graded A, B, C, or D. The adverse reactions of Houyanqing Oral Liquid in the treatment of acute pharyngitis were mainly manifested as abdominal pain, diarrhea, rash, etc., which were relieved after drug withdrawal. In terms of safety, it was considered that Houyanqing Oral Liquid had controllable risk and high safety, which was rated as grade B. Compared with ribavirin aerosol alone, Houyanqing Oral Liquid combined with ribavirin aerosol can significantly improve the total response rate, shorten the time to abatement of fever and di-sappearance of throat pain and mucosal congestion, and alleviate mucosal congestion and cough with sputum. With medium-quality evidence, the effectiveness was rated as grade B. Compared with ribavirin aerosol alone, Houyanqing Oral Liquid combined with ribavirin aerosol had cost-effectiveness advantages in the treatment of acute pharyngitis, and its economy was rated as grade C with the evidence of general quality. For acute pharyngitis, Houyanqing Oral Liquid can shorten the disease course and obviously relieve sore throat. Moreover, it can be used for the treatment of radioactive pharyngitis and oral ulcer, and thus its innovation was rated as grade B. With convenient and simple administration and standard and complete drug information, the suitability of this drug was rated as grade B. Houyanqing Oral Liquid is derived from the folk prescription in Hunan province and has been subjected to real-world studies, and thus the TCM characteristics was rated as grade B. According to the ratings of all the dimensions, the comprehensive value of Houyanqing Oral Liquid in the clinical treatment of acute pharyngitis was determined as grade B, with sufficient evidence and clear results. It is suggested that the results should be conditionally converted into relevant policy of clinical basic drug management according to procedures.

Background: Acute rheumatic fever (ARF) affects millions of children in the third world countries like India. The diagnosis of rheumatic fever is based on the Jones criteria with serological titers, antistreptolysin O titer (ASO), and anti-deoxyribonucleic B (ADB), taken as evidence of recent streptococci infection. There is a lack of recent data available on ASO and ADB titers in children from the Delhi/NCR and thus adequate geographical area-specific cutoffs for the region are not available. Aims and Objectives: The aim of this study is to determine and compare the ASO and ADB antibody titers in children with acute pharyngitis, ARF, rheumatic heart disease (RHD), and in healthy children of the Delhi/NCR region. Materials and Methods: Twenty-six cases of ARF, 51 cases of RHD, 50 cases of acute pharyngitis, and 84 healthy normal children were included in the study. A single ASO and ADB titer measurement was done in these children. Results: The ASO titers was raised in acute pharyngitis – 303 IU/ml (interquartile range [IQR], 142–520 IU/ml) and ARF – 347.5 IU/ml (IQR, 125–686 IU/ml) children in comparison to healthy controls – 163.5 IU/ml (IQR, 133–246.5 IU/ml) and RHD patients – 163 IU/ml (IQR, 98.250–324.500). The ADB titers were highest in ARF patients – 570.5 IU/ml (IQR, 276–922 IU/ml) followed with RHD – 205 IU/ml (IQR, 113.6–456.5), healthy controls – 78.25 IU/ml (IQR, 53.39–128.15 IU/ml), and acute pharyngitis – 75.12 IU/ml (IQR, 64.5–136 IU/ml). The upper limit of normal (ULN) values of ASO and ADB computed from normal healthy children were 262.4 IU/ml and 134.44 IU/ml, respectively, and these can be used as cutoff values for recent streptococcal infection in this geographical area. Conclusions: The median ASO titers in acute pharyngitis group and ARF were significantly raised compared to that of the control group. The ADB titers were raised in ARF and RHD patients albeit the levels were higher in ARF patients. The derived ULN values can be used as cutoff reference. [ABSTRACT FROM AUTHOR]

Explore the effect of compound lobelia oral liquid on acute pharyngitis rabbits model caused by ammonium hydroxide, evaluate its curative effect. Acute pharyngitis rabbit model was prepared by ammonia spray at pharyngeal. After 1 h of the last administration, score the pharyngeal tissue symptoms of rabbits under the condition of naked eyes (score according to the score criteria). Then, take blood from the marginal auricular vein for routine blood tests and serum TNF-α level measure. Take pharyngeal tissue for HE staining, and observe its pathological changes under the microscope. Compared with the blank group, the pharyngeal tissue symptom score and serum TNF-α level in the model group were significantly increased (P < 0.01). The results of blood routine showed that the number of white blood cells and lymphocytes in the model group increased significantly (P < 0.01), and neutrophilic granulocyte percentage decreased significantly (P < 0.01). The infiltration of inflammatory cells in the pharynx tissue was obvious and pathological changes were observed. Compared with the model group, large, middle and small doses of compound lobelia oral liquid group could reduce the scores of pharyngeal tissue symptoms in rabbits with acute pharyngitis induced by ammonia. The large and middle dose compound lobelia oral liquid group could significantly reduce serum TNF-α level and neutrophilic granulocyte percentage, significantly increase the number of white blood cells and lymphocytes (P < 0.01); The small dose compound lobelia oral liquid group could significantly reduce the number of white blood cells and lymphocytes (P < 0.01), there was an increasing tendency to neutrophils and a decreasing tendency to serum TNF-α, but no statistical significance. The large, middle and small doses of compound lobelia oral liquid group all could improve the pathological changes of pharyngeal tissue inflammatory infiltration. Compound lobelia oral liquid has a good effect on rabbit acute pharyngitis model caused by ammonia. [ABSTRACT FROM AUTHOR]

Purpose: Acute pharyngitis is an uncomfortable disorder mostly caused by viruses and for which antibiotics are unwarranted. This study compared lozenges containing ectoine, a natural extremolyte, with hyaluronic acid lozenges and hypertonic saline gargle for symptomatic treatment of acute viral pharyngitis. Methods: This prospective, controlled clinical study, recruited 90 patients with moderate-to-severe pharyngitis symptoms who chose to use either ectoine (n = 35), hyaluronic acid (n = 35), or saline gargle (n = 20). Patients applied their 7-day treatment from the inclusion visit (V1) until the end-of-study visit (V2). Patients' pharyngitis symptoms, general health, general treatment effectiveness and tolerability, and patient compliance were assessed by investigators and patients. Results: The sum score for three primary symptoms (pain on swallowing, urge to cough, and hoarseness) decreased by 79.5% (ectoine), 72.2% (hyaluronic acid), and 44.8% (saline gargle). Both lozenges were significantly superior to saline gargle (P < 0.05). Regarding general health improvement, ectoine was significantly superior to saline gargle (72.5% vs. 45.2%, P < 0.05), but hyaluronic acid (63.3%) was not. At V2, 65.7% of patients receiving ectoine reported "very good" general health vs. 48.6% of those receiving hyaluronic acid and 20.0% using saline gargle. Ectoine was significantly superior (P < 0.05) to both hyaluronic acid and saline gargle in terms of tolerability and patient compliance. No patients taking ectoine reported unpleasant sensations while applying their treatment, whereas almost half of patients using hyaluronic acid lozenges and saline gargle did. Conclusion: Treatment with ectoine lozenges significantly relieves moderate-to-severe symptoms of acute viral pharyngitis and is more effective and tolerable than treatments with hyaluronic acid lozenges and hypertonic saline gargle. [ABSTRACT FROM AUTHOR]

Abstract Objective Observe anti-inflammatory effect and the effect on acute pharyngitis rats model induced by ammonia water of compound Lobelia oral liquid, providing experimental basis for its clinical use. Methods Use egg white establish foot swelling rats model and use carboxymethyl cellulose establish white blood cell migration rats model. Then observe the anti-inflammatory effect of compound Lobelia oral liquid. Use 15% ammonia spray at pharyngeal establish acute pharyngitis rats model, Visual observation and conduct grading of pharyngeal tissue stimulation in rats, measure the levels of TNF-α and IL-6 in serum. Pharyngeal tissue was taken to observe the morphological changes. Result All dose groups of compound Lobelia oral liquid can reduce the rate of foot swelling of rats at all time points (P < 0.01 or P < 0.05), and significantly reduce the number of white blood cells of rats (P < 0.01); And improve the local hyperemia degree, reduce secretion, reduce local swelling of pharyngeal tissue, reduce the serum TNF-α and IL-6 levels of acute pharyngitis rats with different degrees (P < 0.01 or P < 0.05). Conclusion Compound Lobelia oral liquid has a good anti-inflammatory effect on foot swelling and white blood cell migration rats model, as well as significant improvement effect on acute pharyngitis rats model. [ABSTRACT FROM AUTHOR]