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Aerosol antibiotic therapy in children with chronic upper airway infections: a potential alternative to surgery

A Macchi1, P Castelnuovo

  • 1Department of Otorhinolaryngology University of Insubria, Varese, Azienda Ospedaliero Universitaria Ospedale di Circolo e Fondazione Macchi, Varese, Italy. studiodottormacchi@virgilio.it

International Journal of Immunopathology and Pharmacology
|June 10, 2009
PubMed

Insights

Aerosol therapy with thiamphenicol glycinate acetylcysteinate and beclomethasone significantly reduced the need for tonsillectomy and adenoidectomy in children with chronic adenotonsillitis. This treatment also decreased nasal obstruction and infections without adverse events.

Area of Science:

  • Pediatric Otolaryngology
  • Respiratory Medicine
  • Pharmacology

Background:

  • Tonsillectomy and adenoidectomy are primary treatments for chronic/recurrent upper respiratory tract infections in children.
  • Adenotonsillitis often necessitates surgical intervention due to obstructive symptoms and frequent infections.

Purpose of the Study:

  • To evaluate the efficacy of aerosolized thiamphenicol glycinate acetylcysteinate plus beclomethasone in children awaiting tonsillectomy/adenoidectomy.
  • To determine if this combination therapy can prevent or postpone necessary surgeries.

Main Methods:

  • A randomized controlled trial involving 204 children (1-12 years) with chronic adenotonsillitis.
  • Intervention group received aerosolized thiamphenicol glycinate acetylcysteinate (250 mg/day) and beclomethasone (400 µg/day) for 10 days/month over 6 months.
  • Control group received no treatment unless required; follow-up at 4, 7, and 12 months.

Main Results:

  • Significantly fewer patients in the treatment group required surgery (29% vs. 97% in control, p < 0.0001).
  • The therapy led to reduced nasal obstruction and fewer infectious episodes.
  • No treatment-related adverse events were reported, and administration was easy for children.

Conclusions:

  • Aerosol therapy with thiamphenicol glycinate acetylcysteinate and beclomethasone effectively prevents or postpones surgery for chronic adenotonsillitis in children.
  • This approach shows promise as antibiotic prophylaxis for chronic upper airway infections.

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