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Inhaled hyaluronic acid as ancillary treatment in children with bacterial acute rhinopharyngitis
A Varricchio1, M Capasso1, F Avvisati1
1Associazione Italiana Vie Aeree Superiori (AIVAS) - Study Group on respiratory infections, Italy.
Insights
Adding hyaluronic acid (HA) to topical antibiotics significantly improved treatment for bacterial acute rhinopharyngitis (ARP) in children. This combination therapy reduced symptoms and bacterial load more effectively than antibiotics alone.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Acute rhinopharyngitis (ARP) is a common childhood illness with significant socio-economic impact.
- Topical antibiotics are standard for bacterial ARP, but efficacy can be enhanced with ancillary treatments.
- Hyaluronic acid (HA) has emerged as a potential therapeutic agent for upper respiratory conditions.
Discussion:
- This study investigated the efficacy of intranasal hyaluronic acid (HA) as an adjunct to topical antibiotic therapy in pediatric bacterial ARP.
- The research involved 51 children randomly assigned to receive either thiamphenicol alone or thiamphenicol with HA via nasal nebulization for 10 days.
- Outcomes measured included symptom perception (sVAS), nasopharyngeal spotting, neutrophil count, and bacterial load.
Key Insights:
- Both treatment groups showed significant symptom reduction, but the thiamphenicol plus HA group demonstrated superior improvement.
- The addition of HA led to statistically significant greater reductions in symptom severity (sVAS), neutrophil count, and bacterial presence.
- These findings suggest that intranasal HA can enhance the effectiveness of topical antibiotics in treating bacterial ARP in children.
Outlook:
- Further research could explore optimal HA concentrations and delivery methods for pediatric respiratory infections.
- Investigating the long-term effects and potential for preventing recurrent infections with HA-based therapies is warranted.
- This study opens avenues for developing more effective combination treatments for common childhood respiratory ailments.
Abstract:
Acute rhinopharyngitis (ARP) is the most common upper respiratory infection in children and represents a social problem for both the pharmaco-economic impact and a burden for the family. Topical antibiotic therapy is usually effective in bacterial ARP, but ancillary treatment might improve its efficacy. Hyaluronic acid (HA) is a promising molecule that has been recently proposed in upper respiratory disorders. Therefore, the purpose of this study was to evaluate the effects of ancillary HA treatment in children with bacterial ARP. Globally, 51 children (27 males, mean age 5.9 ± 2.1 years) with bacterial ARP were enrolled in the study. At baseline, children were randomly assigned to the treatment with: 125 mg of thiamphenicol diluted in 4 mL of saline isotonic solution twice daily (group A) or with 125 mg of thiamphenicol plus 4 ml of sodium hyaluronate 0.2% plus xylitol 5% (Aluneb, Sakura Italia) twice daily (group B) administered by the nasal device Rinowash (Airliquide Medical System, Italy) and connected to an aerosol nebulizer with pneumatic compressor (1.5 bar per 5 L/min) Nebula (Airliquide Medical System, Italy), for 10 days. sVAS, nasopharyngeal spotting, neutrophils and bacteria were assessed at baseline and after the treatment. Both treatments induced significant reduction of symptom perception, spotting, neutrophil and bacteria count. However, thiamphenicol plus HA was able to significantly induce a greater effect on sVAS (p=0.006), neutrophil count (p=0.01), and bacteria count (p=0.0003) than thiamphenicol alone. In conclusion, this study provides the first evidence that intranasal HA, as ancillary treatment, may be able to improve topical antibiotic efficacy in children with bacterial ARP.
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