[Optimization of prophylaxis of relapses of primary erysipelas with the use of cyclopheron]

The aim of the work was to evaluate efficiency of combined therapy of primary erysipelas with the use of immunomodulator cyclopheron (CP), its influence on the clinical picture of the disease, frequency of relapses, lipid peroxidation (LPO) and dynamics of anti-inflammatory cytokines (IL-1b, TNF-alpha). Some of the 87 patients with uncomplicated primary erysipelas of different localization were followed up for 2 years. Lipid peroxidation and dynamics of anti-inflammatory cytokines were studied in 65 patients. A group of 36 patients were given cyclopheron (Polisan, Russia) in addition to standard treatment including etiotropic, pathogenetic and symptomatic therapy. Cyclopheron was first administered by intramuscular injections and thereafter as tablets. Cyclopheron reduced duration of asthenovegetative syndrome, hyperemia, infiltration and regional lymphadenitis compared with controls, but did not significantly alter duration of fever and local oedema. The drug decreased the frequency of early complications as demonstrated by "absolute risk reduction" to 0.35 [0.19; 0.51]. Plasma levels of malonic dialdehyde, lipid hydroperoxides, and TNF-alpha in the reconvalescence period were lower than in control subjects suggesting optimization of homeostasis and correction of inflammatory processes. It is supposed that efficiency of cyclopheron in patients with primary erysipelas may be due to its immunomodulatory activity that prevents formation of chronic foci of Staphylococcal infections in derma and regional lymph nodes.