Varricchio A, Capasso M, Avvisati F, Varricchio A M, De Lucia A, Brunese F P, Ciprandi G
Associazione Italiana Vie Aeree Superiori (AIVAS) - Study Group on respiratory infections, Italy.
J Biol Regul Homeost Agents. 2014 Jul-Sep;28(3):537-43.
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.
急性鼻咽炎（ARP）是儿童最常见的上呼吸道感染，因其药物经济学影响和家庭负担而成为一个社会问题。局部抗生素治疗通常对细菌性ARP有效，但辅助治疗可能会提高其疗效。透明质酸（HA）是一种有前景的分子，最近已被应用于上呼吸道疾病。因此，本研究的目的是评估辅助HA治疗对细菌性ARP儿童的影响。全球共有51名细菌性ARP儿童（27名男性，平均年龄5.9±2.1岁）参与了该研究。在基线时，儿童被随机分配接受以下治疗：125mg甲砜霉素稀释于4mL等渗盐溶液中，每日两次（A组）；或125mg甲砜霉素加4mL 0.2%透明质酸钠加5%木糖醇（Aluneb，意大利樱花公司），每日两次（B组），通过鼻腔装置Rinowash（意大利液化空气医疗系统公司）给药，并连接到带有气动压缩机（每5L/min 1.5巴）的雾化器Nebula（意大利液化空气医疗系统公司），持续10天。在基线和治疗后评估视觉模拟评分（sVAS）、鼻咽部斑点、中性粒细胞和细菌情况。两种治疗均能显著降低症状感知、斑点、中性粒细胞和细菌计数。然而，与单独使用甲砜霉素相比，甲砜霉素加HA能够显著对sVAS（p = 0.006）、中性粒细胞计数（p = 0.01）和细菌计数（p = 0.0003）产生更大的影响。总之，本研究首次提供证据表明，鼻内HA作为辅助治疗，可能能够提高细菌性ARP儿童局部抗生素的疗效。
