Potential active constituents responsible for treating acute pharyngitis in the flowers of Hosta plantaginea (Lam.) Aschers and their pharmacokinetics

In Asia, the flower of Hosta plantaginea (Lam.) Aschers (hosta flower) is both an edible food and medicine. The hosta flower is often used as a material for cooking porridge...

Antipharyngitis Effects of Syringa oblata L. Ethanolic Extract in Acute Pharyngitis Rat Model and Anti-Inflammatory Effect of Ir-Idoids in LPS-Induced RAW 264.7 Cells

Acute pharyngitis is an inflammation of the pharyngeal mucous membrane and submucous lymphoid tissues. Unsatisfactory treatment and repeated occurrences might cause chronic pharyngitis and other complications. Syringa oblata L. (S. oblata) is a traditional Chinese medicine that exhibited a significant therapeutic effect on various inflammatory diseases. Its commercial drug Yan Li Xiao (YLX) capsule is used as a cure for the treatment of inflammatory diseases, such as bacillary dysentery, tonsillitis, bronchitis, and acute gastroenteritis. However, studies about S. oblata relieving acute pharyngitis are rare. In this study, high-performance liquid chromatography (HPLC) was used to analyze the chemical profile of S. oblata, and the bioactive phytoconstituents were isolated and identified by nuclear magnetic resonance (NMR) and mass spectrometry. An ammonia-induced acute pharyngitis rat model was established to estimate the protective effect of S. oblata in vivo for the first time. The severity of pharyngitis was observed by appearance index and HE staining. The cytokines expression was performed by ELISA. Crucial proteins expression associated with TLR4/NF-κB/MAPK and NLRP3 inflammasome signaling pathways were analyzed by western blotting and immunohistochemistry. Furthermore, the anti-inflammatory effect of isolated compounds was evaluated by suppressing lipopolysaccharide- (LPS-) induced NO generation and regulating the cytokines levels in RAW 264.7 cells. The results showed that S. oblata exhibited a protective effect in the ammonia-induced acute pharyngitis rat model, and the compounds exert potential anti-inflammatory properties against LPS-activated RAW 254.7 cells.

Outdoor Temperature as an Independent Risk Factor for Acute Pharyngitis Incidence: A Preliminary Study

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.

Clinical Study of Iodine-Glycerol Combined With Valvaguang in the Treatment of Acute Pharyngitis

To explore the clinical effect of iodine-glycerol combined with Weivaguang in the treatment of acute pharyngitis. Methods: A total of 118 patients with acute pharyngitis treated in our hospital from July 2017 to December 2019 were selected as the research object, and they were randomly divided into 59 cases in the control group and the study group by random number table method. The group was given Weivaguang treatment on the basis of the control group, comparing the disappearance time, signs or symptoms score, inflammatory factors [tumor necrosis factor alpha (TNF-±), C-reactive protein (CRP), interleukin (IL-6)] Level and therapeutic effect. Results: The throat disappearance time, throat pain disappearance time, hoarseness disappearance time, and pharyngeal edema disappearance time of the study group were significantly shorter than those of the control group, and the differences were statistically significant (P <0.05). Repeated measurement data analysis of variance showed that the difference in the subject’s intra-subject effect was statistically significant (P <0.05), with the group factor as the source and the time factor and group interaction as the source within the subject There was no statistically significant difference in effect comparison (P > 0.05), which shows that the signs or symptoms scores have a tendency to change with time; the sign or symptom scores of the two groups are compared: after 5 days of treatment <2 days after treatment <before treatment, the differences are both Statistically significant (P <0.05); before the treatment, there were no statistically significant differences in the signs or symptoms scores between the two groups (P > 0.05). After 2 days of treatment and 5 days of treatment, the signs or symptoms of the study group were significantly lower than the control Group, the difference was statistically significant (P <0.05). Before treatment, the levels of TNF-±, CRP, and IL-6 were not statistically significant (P > 0.05); after treatment, the levels of TNF-±, CRP, and IL-6 decreased in both groups, and the study group and the control The group comparison was significantly lower, and the differences were statistically significant (P <0.05). The therapeutic effect of the study group was better than that of the control group (P <0.05), and the total effective rate of treatment in the study group was 96.61%, significantly higher than 81.36% of the control group, the difference was statistically significant (P <0.05). Conclusion: The application of iodine-glycerin combined with valvaguang in the treatment of acute pharyngitis can effectively shorten the disappearance time of patients’ clinically relevant indicators, relieve signs or symptoms, reduce the body’s inflammatory response, and improve the therapeutic effect.

Prevalence of Microorganisms in Acute Pharyngitis from Throat Swab in a tertiary care hospital

Background: Acute pharyngitis is the inflammation of the mucous membrane of oropharynx which is caused by various infectious organisms like bacteria, viruses and fungi. The other less common seen causes include allergies and gastro-esophageal reflux disease. Aim: To look for range of microorganisms involved in causing acute pharyngitis on throat swab specimens. Methods: After getting consent all the pharyngitis patients attending ENT Department at Akbar Niazi Teaching Hospital (ANTH), Islamabad from January to June 2017 were included in the study. From total of 100 patients throat swabs were obtained by established aseptic method and were sent for culture. The organisms involved were recognized by biochemical tests & their propensity to antimicrobial agents was established by established methods. Data was entered and analyzed by using SPSS v.21. Results: Out of 100 specimens’ microorganisms were identified in 25 specimens while 75 specimens had no growth. Streptococcus pyogenes was the frequently seen organism 9(90%), while the list was followed by Staphylococcus aureus 14(56%) and Candida albicans 3(12%). In 40% single pathogen was identified with Streptococcus pyogenes in 9 samples (90%) and Staphylococcus aureus in 1(10%), whereas 60% of the culture reports were that of the mix infection. Conclusion: The study concluded that streptococcus pyogenes and staphylococcus aureus were responsible for majority of single organism infections, while candida albicans together with these bacteria were isolated from mixed infections. Keywords: Pharyngitis; Streptococcus pyogenes; Throat; Microorganisms.

Positive Rate of Tests for Group a Streptococcus and Viral Features in Children with Acute Pharyngitis

Group A streptococcus (GAS) is an important cause of acute pharyngitis. We investigated the positive rate of GAS tests and clinical viral features in children with acute pharyngitis. A retrospective review was conducted for patients <15 years old with both rapid antigen detection test (RADT) and throat culture results. Patients were excluded if they were diagnosed with influenza or had received antibiotics within two weeks before these tests. A total of 377 patients were eligible. The median age of patients was 3.5 years, and 45.4% of total patients were <3 years old. Among all patients, 68.7% had at least one viral feature, and 39% had more than two. The overall positiv rate for GAS was 11.4%. The GAS positive rate was significantly lower in patients <3 years old than in older patients (1.8% vs. 19.4%, p < 0.0001). The overall sensitivity and specificity of RADT were 75.0% (95% CI: 57.8–87.9) and 97.9% (95% CI: 95.8–99.2), respectively. The GAS positive rate was not significantly different between patients with and without viral features (12.4% vs. 9.3%, p = 0.4854). In patients aged 3–14 years, the GAS positive rate was not associated with the modified Centor score or the frequency of clinical viral features. Despite a low prevalence of GAS pharyngitis, testing for GAS was frequently performed in children <3 years old in this study. Appropriate use of laboratory testing for GAS pharyngitis and judicious prescription of antibiotics were imperative.

Evidence of the Efficacy of Flurbiprofen 8.75 mg Lozenges for Patients Receiving Antibiotics for Laboratory-Confirmed Streptococcal Pharyngitis

Objectives: To determine the efficacy of flurbiprofen 8.75 mg lozenges for patients with laboratory-confirmed streptococcal pharyngitis both before and concomitant with antibiotics. Methods: This post hoc analysis comprised adult participants from 2 earlier randomized, double-blind, placebo-controlled studies evaluating the analgesic efficacy of flurbiprofen 8.75 mg lozenges in acute pharyngitis. Throat swabs were obtained to diagnose streptococcal infection. Prior to and 2 hours after each dose of study medication (flurbiprofen or placebo lozenges), patients rated 3 symptoms of acute pharyngitis (sore throat pain, difficulty swallowing, and swollen throat) using visual analogue scales. Appropriate antibiotic treatment was initiated when culture results were reported. Mean changes in each pharyngeal symptom were compared over the immediate 24 hours before and during the initial 24 hours of antibiotic treatment. Results: Twenty-four patients provided both preantibiotic and concomitant antibiotic efficacy outcomes. Relief of throat pain was 93% greater in the flurbiprofen group than in the placebo group before antibiotic coadministration and 84% greater than placebo during antibiotic administration (both P < .05). Relief of difficulty swallowing was 71% greater in the flurbiprofen group than in the placebo before antibiotic administration (P = .16) and 107% greater during concomitant antibiotic administration (P = .04). Relief of the sensation of throat swelling was 295% greater with flurbiprofen than placebo before antibiotic administration (P = .008) and 70% greater during concomitant antibiotic administration (P = .06). For placebo-treated patients, relief from throat pain and difficulty swallowing were similar before and during antibiotic treatment (P > .05), indicating no benefit with antibiotic administration for these symptoms. No treatment-related discontinuations or serious adverse events were reported. Conclusions: Irrespective of antibiotic use, flurbiprofen 8.75 mg lozenges provide well-tolerated, effective relief of pharyngeal symptoms in patients with streptococcal infection. In the 24 hours after administration, antibiotics provide no relief of throat pain or difficulty swallowing beyond the topical demulcent effects of placebo lozenges.

Prevalence and antibiotics susceptibility profiles of Streptococcus pyogenes among pediatric patients with acute pharyngitis at Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia

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.