No1(1) 2018
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DOI 10.37219/2528-8253-2018-1-51 |
Al Hariri Mahmoud Jоmaa, Semenenko SI, Zaikov SV, Popovich
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Application of bacteriophage in complex treatment of rinosinusites
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Al Hariri Mahmoud Jоmaa
Vinnitsya National Pirogov Memorial Medical University
E-mail: alhariri.mahmoud75@gmail.com
https://orcid.org/0000-0002-8669-7026
Semenenko Svitlana I.
Vinnitsya National Pirogov Memorial Medical University
https://orcid.org/0000-0002-6124-1938
Zaikov Sergey V.
Shupik National Medical Academy of Postgraduate Education
Department of Phthisiology and Pulmonology, Professor
Doctor of Medical Sciences, Associate Professor
E-mail: zaikov1960@gmail.com
https://orcid.org/0000-0002-9276-0490
Popovych Vasyl I.
Ivano-Frankivsk National Medical University
Head of Department of Otorhinolaryngology – Head and Neck Surgery
Doctor of Medical Sciences, Professor
E-mail: popovychvasyl@gmail.com |
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Abstract
Materials and methods: Sixty patients aged 18 to 85 years who were
ill with acute bacterial rhinosinusitis were examined. the average age of
which was 36 ± 2 years. The research was carried out on the basis of the ENT
Department of the City Clinical Emergency Hospital and the Municipal Medical
Diagnostic Center of the city of Vinnitsya. All patients were divided into
two groups. 30 patients with acute bacterial rhinosinusitis included in the
baseline therapy group 1 (group of comparison), which included: systemic
antibiotic therapy (selective drugs - cephalosporins II-III generation),
anti-inflammatory (topical corticosteroids, non-steroidal anti-inflammatory
drugs), irrigation therapy, local decongestants and drugs with mucolytic,
secretomotor and secretory effect. Group 2 (main group) consisted of 30
patients with a diagnosis of acute bacterial rhinosinusitis, the
bacteriophage (sta-
phylococcal or piophage) was added to the baseline therapy. Patients
undergoing bacteriophage (staphylococcus or piophage) were injected as drops
in the nose, 3-4 drops in each nasal passage three times a day for 7-10 days
or after catheterization of the nasal sinus was washed with sterile 0.9%
sodium chloride solution, after which was injected through a catheter of 3-5
ml of a bacteriophage into the sinus cavity once a day for 7-10 days. The
level of secretory immunoglobulin A (sIgA) was determined using an
enzyme-linked immunosorbent assay in nasal secret. The statistical
processing of the results was carried out using the statistical computer
program Statistica for Windows, v.12 using parametric and nonparametric
methods for evaluating the results.
Results: Prior to the median treatment, the concentration of sIgA in
nasal washes in group 1 was 0.92 mg / L, the interquartile interval of
P25-P75 was in the range of 0.74; 1.15 mg / l, and in group 2 - median 0.94
mg / L, P25-P75 - 0.75-1.10 mg / l (p> 0.05). It was found that standard
therapy was accompanied by a probable increase The concentration of sIgA in
the nasal secret in 7-10 days from the beginning of treatment was 2.1 times
(p <0.001), compared to the indicator before treatment, while the rates
before treatment and after 12 weeks were not statistically significantly
different (p = 0.051). Against the background of combination therapy, which
included a bacteriophage, there was a more pronounced increase in the level
of sIgA - after 7-10 days in 3 times (p <0,001), in 12 weeks in 2,5 times (p
<0,001), compared with the indicator before treatment. A comparison of the
mean values of sIgA concentration in the nasal secret between the study
groups revealed that in 7-10 days and 12 weeks, the concentration of sIgA in
patients receiving a bacteriophage was 21.3% and 43.9% higher, respectively,
than in
patients in the base group therapy (p = 0.048 and p <0.001). It was
established that modified therapy with the use of bacteriophage contributes
to the prevention of chronic acute bacterial rhinosinusitis, which was 36.6%
less frequent than in the basic therapy group without bacteriophage (CS:
0.18; 95% CI: [0.05-0, 58]). |
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Keywords
rhinosinusitis, bacteriophage, local immunity, secretory immunoglobulin A. |
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