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Effect of chlorhexidine gluconate and benzydamine hydrochloride mouth spray on clinical signs and quality of life of patients with streptococcal tonsillopharyngitis: multicentre, prospective, randomised, double-blinded, placebo-controlled study

Published online by Cambridge University Press:  11 February 2011

C Cingi ,
M Songu ,
A Ural ,
N Erdogmus ,
M Yildirim ,
H Cakli  and
C Bal
C Cingi
Affiliation:
Department of Otorhinolaryngology, Osmangazi University Medical Faculty, Eskisehir, Turkey
M Songu
Affiliation:
Department of Otorhinolaryngology, Izmir Ataturk Research and Training Hospital, Izmir, Turkey
A Ural*
Affiliation:
Department of Otorhinolaryngology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
N Erdogmus
Affiliation:
Department of Otorhinolaryngology, Osmangazi University Medical Faculty, Eskisehir, Turkey
M Yildirim
Affiliation:
Department of Otorhinolaryngology, Dicle University Medical Faculty, Diyarbakir, Turkey
H Cakli
Affiliation:
Department of Otorhinolaryngology, Osmangazi University Medical Faculty, Eskisehir, Turkey
C Bal
Affiliation:
Department of Biostatistics, Osmangazi University Medical Faculty, Eskisehir, Turkey
*
Address for correspondence: Dr Ahmet Ural, Karadeniz Teknik Üniversitesi Tıp Fakültesi Farabi Hastanesi, Kulak Burun Boğaz Hastalıkları Anabilim Dalı, 61080 Trabzon, Turkey Fax: +904623250518 E-mail: ahmetural2001@yahoo.com
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Abstract

Objective:

To assess the effect of chlorhexidine gluconate and benzydamine hydrochloride mouth spray, used in conjunction with antibiotic treatment, on the intensity of clinical signs and quality of life of patients with group A streptococcal tonsillopharyngitis.

Methods:

Patients (n = 147) with streptococcal tonsillopharyngitis were recruited and randomly allocated to either the treatment group (penicillin plus chlorhexidine and benzydamine; n = 72) or control group (penicillin plus placebo; n = 75). Blinded assessments were conducted before and after 10 days' treatment, using an intensity rating scale for clinical sign severity, a visual analogue scale for subjective health state, the Short Form 36 Health Questionnaire for quality of life, and a customised questionnaire for side effects.

Results:

The treatment group showed a statistically significant reduction in the intensity of clinical signs, compared with the control group. On treatment day 7, there was no significant difference in quality of life between the treatment and control groups. The treatment drugs were well tolerated, and no serious adverse events were observed.

Conclusion:

Chlorhexidine gluconate and benzydamine hydrochloride mouth spray, added to standard antibiotic treatment, significantly alleviate the intensity of clinical signs in patients with streptococcal pharyngitis. Further research is needed using larger sample sizes or alternative control groups.

Keywords

PharyngitisTonsillitisChlorhexidineBenzydamineTherapeutics
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 6 , June 2011 , pp. 620 - 625
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Melio, FR, Holmes, DK. Upper respiratory tract infections. In: Rosen, P, Barkin, R. Emergency Medicine: Concepts and Clinical Practice, 4th edn.St Louis: Mosby, 1998;1529–53Google Scholar
2Shores, CG. Infections and disorders of the neck and upper airway. In: Tintinalli, JE, Kelen, GD, Stapczynski, JS. Emergency Medicine: a Comprehensive Study Guide, 6th edn.New York: McGraw-Hill, 2004;1494–501Google Scholar
3Scottish Intercollegiate Guidelines Network. Management of Sore Throat and Indications for Tonsillectomy. Guideline No: 117 April 2010 (http://www.sign.ac.uk/guidelines/fulltext/117/index.html)Google Scholar
4Del Mar, CB, Glasziou, PP, Spinks, AB. Antibiotics for sore throat. Cochrane Database Syst Rev 2006;(4):CD000023Google Scholar
5National Institute for Health and Clinical Excellence. NICE Guideline. Respiratory tract ınfections – antibiotic prescribing. Prescribing of antibiotics for self-limiting respiratory tract ınfections ın adults and children in primary care. In: http://www.nice.org.uk/nicemedia/pdf/CG69FullGuideline.pdf [16.01.2001]Google Scholar
6Wewers, ME, Lowe, NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Research in Nursing and Health 1990;13:227–36CrossRefGoogle ScholarPubMed
7Diaz-Buxo, JA, Lowrie, EG, Lew, NL, Zhang, H, Lazarus, JM. Quality-of-life evaluation using Short Form 36: comparison in hemodialysis and peritoneal dialysis patients. Am J Kidney Dis 2000;35:293–300CrossRefGoogle ScholarPubMed
8McHorney, CA, Ware, JE, Raczek, AE. The MOS 36-item short form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993;31:247–63CrossRefGoogle ScholarPubMed
9Wei, JL, Kasperbauer, JL, Weaver, AL, Boggust, AC. Efficacy of single-dose dexamethasone as adjuvant therapy for acute pharyngitis. Laryngoscope 2002;112:87–93CrossRefGoogle ScholarPubMed
10Bisno, AL, Gerber, MA, Gwaltney, JM, Kaplan, EL, Schwartz, RH, Infectious Diseases Society of America. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Infectious Diseases Society of America. Clin Infect Dis 2002;35:113–25CrossRefGoogle Scholar
11Ebell, MH. Making decisions at the point of care: sore throat. Fam Pract Manag 2003;10:68–9Google ScholarPubMed
12Dajani, A, Taubert, K, Ferrieri, P. Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the American Heart Association. Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever: a statement for health professionals. Pediatrics 1995;96:758–64CrossRefGoogle ScholarPubMed
13American Academy of Pediatrics. Committee on Infectious Diseases. American Academy of Pediatrics. Committee on Infectious Diseases. Severe invasive group A streptococcal infections: a subject review. Pediatrics 1998;101:136–40CrossRefGoogle Scholar
14Spadetto, CC, Camara, SM, Ingles, MJA, Escuriet, JM, Barcelo, IC, Sanchez, FR. Rational use of antibiotics in pediatrics: impact of a rapid test for detection of beta-haemolytic group A streptococci in acute pharyngotonsillitis [in Spanish]. An Esp Pediatr 2000;52:212–19Google Scholar
15Efstratiou, A. Group A streptococci in the 1990s. Antimicrob Chemother 2000;45Suppl:3–12CrossRefGoogle Scholar
16Matthijs, S, Adriaens, PA. Chlorhexidine varnishes: a review. J Clin Periodontol 2002;29:1–8CrossRefGoogle ScholarPubMed
17Killoy, WJ. The use of local-delivered chlorhexidine in the treatment of periodontitis. Clinical results. J Clin Periodontol 1988;25:953–8CrossRefGoogle Scholar
18Burgess, JA, Johnson, BD, Sommers, E. Pharmacological management of recurrent oral mucosal ulceration. Drugs 1990;39:54–65CrossRefGoogle ScholarPubMed
19Emilson, CG. Susceptibility of various microorganisms to chlorhexidine. Scand J Dent Res 1977;85:255–65Google ScholarPubMed
20Hennessey, TD. Antibacterial properties of Hibitane. J Clin Periodontol 1977;4:36–48CrossRefGoogle ScholarPubMed
21Newman, MG, Hulem, C, Colgate, J, Anselmo, C. Antimicrobial susceptibility of plaque bacteria. J Dent Res 1979;58:1722–32CrossRefGoogle ScholarPubMed
22Hesselgren, SG, Dahl, GM, Larje, O. In vitro experiments with chlorhexidine on pure bacterial and fungal cultures from the mouth. Swed Dent J 1971;64:801–6Google ScholarPubMed
23Briner, WW, Grossman, E, Buckner, RY, Rebitski, GF, Sox, TE, Setser, RE et al. Effect of chlorhexidine gluconate mouth rinse on plaque bacteria. J Periodont Res 1986;21(suppl 6):44–52CrossRefGoogle Scholar
24Ferretti, GA, Ash, RC, Brown, AT, Largent, BM, Kaplan, A, Lillich, TT. Chlorhexidine for prophylaxis against oral infections and associated complications in patients receiving bone marrow transplants. J Am Dent Assoc 1987;114:461–7CrossRefGoogle ScholarPubMed
25Field, EA, Allan, RB. Review article: oral ulceration aetiopathogenesis, clinical diagnosis and management in the gastrointestinal clinic. Aliment Pharmacol Ther 2003;18:949–62CrossRefGoogle ScholarPubMed