RU2474431C1 - Method of treating acute and aggravated chronic laryngitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine and aims at treating acute and aggravated chronic laryngitis. What is involved is specific antibioticotherapy per os with additional examination of microflora starting from the 3^rd-5^th day of the therapy followed by instillations of specific, result-related bacteriophagues into the larynx in the amount of 0.5-1.0 ml in acute laryngitis for 7-10 days, and in aggravations for 10-14 days.

EFFECT: method provides higher clinical effectiveness ensured by a lower number of side effects and complications, and a reduced length of treatment.

16 tbl, 2 ex

Description

The invention relates to medicine, namely to otorhinolaryngology and phoniatrics, and can be used in the complex treatment of acute and exacerbation of chronic laryngitis.

Issues related to the treatment of patients with acute inflammatory diseases of the upper respiratory tract seem extremely relevant [3]. Currently, the treatment of patients with inflammatory diseases of the larynx is difficult, in most cases multi-stage, long, requires the use of numerous combined methods using specialized equipment and highly qualified medical personnel [6].

Existing treatment methods are diverse [8, 9, 12, 14, 25], but are not always effective and require significant treatment costs [10]. An increase in the resistance of microorganisms and changes in the etiological structure of laryngeal infections indicate the need to review therapeutic approaches, in particular, it is relatively advisable to prescribe antibacterial drugs in this situation [17, 18].

There is a method of treating chronic hyperplastic laryngitis by directly introducing into the vocal folds or subglottic space of the intralaryngeal inducers of interferon - poludan or cycloferron [4].

The disadvantages of the method are:

1. Injection into the under-storage space is allowed only in stationary conditions, and not on an outpatient basis;

2. The injection method into the vocal folds or the back space is dangerous for the development of complications, such as hemorrhage, abscesses, which is unacceptable for persons with voice and speech professions.

There is a method of treating chronic hyperplastic laryngitis by intravenous administration of immunoglobulin "Immunovenin" in an amount of 25.0 ml at a rate of 10-20 drops per minute [1].

The disadvantages of the method are:

1. Intravenous administration of a drug and possible complications.

2. The need for a treatment room and special equipment.

There is a method of treating acute and chronic laryngitis by the method of infusion of oils into the larynx [2, 3, 13]. This method also has its drawbacks:

1. A prolonged infusion of oils into the larynx leads to the development of oleomas in the larynx and trachea.

2. It is impossible to start working for voice professionals immediately after this procedure. The singer can continue his work only after 2 hours.

Closest to the proposed is a comprehensive method for the treatment of acute and chronic laryngitis, including the injection of various medicinal substances into the larynx [13]. However, it has several disadvantages depending on which drug is used.

The disadvantages of the method are:

1. A prolonged infusion of antibiotic solutions leads to the development of candidiasis of the laryngeal mucosa, which is very undesirable, especially in adults.

2. Prolonged infusion of a suspension of hydrocortisone and other hormonal agents leads to the development of subatrophy of the mucosa.

The combined infusion of drugs significantly enhances their side effects and can cause an allergic reaction in the patient.

To combat inflammatory diseases and complications, new types and classes of antibiotics are being developed. However, resistance is rapidly developing towards them. In this regard, many researchers talk about a serious "crisis of antibacterial therapy" [9]. All this makes us look for new approaches to the prevention and treatment of inflammatory diseases. One such approach was the return to the use of bacteriophages, which the medical community temporarily abandoned in the mid-20th century with the invention of broad-spectrum antibiotics. Over the past 5 years, a significant increase in the number of scientific articles in this direction has been noted. Classical and latest clinical studies, as well as numerous animal experiments have shown that phage therapy is an effective and safe alternative to antibiotics in the treatment of bacterial infections [19, 20, 21, 22, 23, 24].

A new technical task is to increase clinical efficiency by reducing the number of side effects and complications and reducing the duration of disability while maintaining accessibility and ease of use

To solve the problem in a method of treating acute and exacerbation of chronic laryngitis by carrying out specific antibiotic therapy per os from 3-5 days from the onset of the disease, in addition to acute laryngitis, instillation of specific bacteriophages in the form of infusions into the larynx in the amount of 0.5-1.0 ml within 7-10 days, and with exacerbations within 10-14 days, while in complicated cases, a specific bacteriophage of 1 tbsp. 3 times a day for 2 weeks.

The method is as follows.

Each patient undergoes a study of the microflora of the larynx and its sensitivity to antibiotics. The sensitivity of microorganisms to antibiotics is determined by the method of discs in accordance with the "Methodological guidelines for determining the antibiotic sensitivity of microorganisms to antibiotics by diffusion into agar using discs", approved by the Ministry of Health of the USSR (order No. 535 of April 22, 1985) and the Instructions for the use of discs to determine sensitivity to antibiotics, approved by the head of the department for the introduction of new drugs and medical equipment of the Ministry of Health of the USSR from 12.10.84. The biomaterial is obtained by taking ma Single with laryngeal mucosa in vestibular folds mezhcherpalovidnogo space and mucosal vocal folds with a cotton swab moistened with sterile saline. The sensitivity of microorganisms to antibiotics is determined by three degrees: sensitive to the antibiotic (S), moderately resistant to the antibiotic (I), resistant to the antibiotic (R). In the same way, sensitivity to bacteriophages is detected. Patients are examined before treatment and after a course of therapy.

It is known that exacerbation of chronic laryngitis begins most often either with hypothermia of the patient, or with a viral infection. However, as shown by numerous data [3, 8, 10, 12, 14], a bacterial infection that begins to play a large role very quickly plays in this process. It is known that the microflora of the larynx and trachea differ in composition from the microflora of the upper respiratory tract - the pharynx and nasal cavity. This is evidenced by numerous studies of scientists and microbiologists [5, 8, 15]. According to our data, it has significant differences in 67% of patients. Therefore, at the beginning of rational antibiotic therapy, a study of the microflora of the larynx is carried out and its sensitivity to antibiotics is determined. The ineffectiveness of treatment with systemic antibacterial drugs on an outpatient basis in patients with exacerbation of chronic laryngitis is associated with an incorrect choice of the antibiotic itself and its resistance to microorganisms [8, 11, 15].

The antibacterial effect of bacteriophages is due to the specific lysis of pathogenic bacteria in the focus of inflammation. It has been established that bacteriophages stimulate regeneration processes and have a stimulating effect on the patient’s immune system. Positive qualities of bacteriophages were noted: the absence of toxic effects on the body, the development of allergic reactions, dysbiosis [9, 16]. Infusion of specific bacteriophages in the larynx of 0.5-1 ml is due to the size of the larynx itself. The sizes of the larynx in men and women have their own differences. Because the larynx is a hormone-dependent organ and usually the larynx in men is larger than the larynx in women.

As shown by the analysis of clinical observation data for patients with acute and exacerbation of chronic laryngitis, it is sufficient to treat bacteriophages within 7-10 days in case of an acute course of the disease and with pronounced positive dynamics, and in case of exacerbation of chronic laryngitis it is advisable to prescribe bacteriophages within 10-14 days. In the case of a severe course of the disease, weak positive dynamics of the inflammatory process, an additional intake of bacteriophages inside is indicated, 1 tablespoon 3 times a day for two weeks (14 days).

As an example, we provide extracts from outpatient records of two patients treated by the claimed method.

Clinical examples

Example 1

Patient T-in L.A. Born in 1989, the treatment period is 14 days.

Diagnosis: chronic catarrhal laryngitis. He complained of sore throat, hoarse voice, dry cough.

From the anamnesis: the patient often gets sick, more than 4 times a year. In childhood - frequent tonsillitis, pneumonia 3 years ago. The patient is tall, asthenic physique, smokes.

Objectively: larynx - hyperemia of the mucous membrane of the larynxopharynx is noted, true vocal folds are injected, thickened, spindle-shaped edema along the edge. With phonation, the closure of the true vocal folds is incomplete, in the interchaloid space there is an accumulation of mucosal discharge. In the gaps of the tonsils there is an accumulation of purulent-caseous plugs. Nasal breathing is free.

Auditory assessment of voice: hoarse, hoarse voice, pronounced dysphonia (4), aspiratory attack - solid.

Examined for microflora and sensitivity to antibiotics from the larynx. As a result of sowing, the combined microflora of S. Aureus + Str. Pyogenes from the laryngeal mucosa, and the positive sensitivity of St. Aureus was revealed only to ciprofloxacin, to other antibiotics: cefatoxime, tetracycline, azithromycin and vancomycin, the microorganism was not sensitive. The treatment was carried out according to the proposed method: ciprolet, staphylococcal and streptococcal bacteriophage in 0.5 ml topically and inside 1 tbsp. 3 times a day for 14 days. Remission was more than 3 months and continues to this day. The patient feels well, does not show complaints.

Laryngoscopic picture and auditory assessment of the patient’s voice in dynamics: before treatment, the indicators corresponded to a pronounced degree (3). After treatment, the voice recovered to normal (0-1) in the shortest possible time of 14 days (Table 1).

Computer analysis of voice showed an improvement in some objective ways: the signal-to-noise ratio HNR increased from 17.8 dB to 24.9 dB (40%). Indicators Jitter and Shimmer decreased to optimal values: Jitter - from 1.48 to 0.33, Shimmer - from 7.35 to 0.84, which determines the positive dynamics of changes in the functional state of the patient (Table 2).

According to electronic stroboscopy, the index of vibratory insufficiency (IVN) decreased on average from 1.2 to 1, which is normal (Table 3).

The dynamics of the blood test is positive: the number of leukocytes decreased by 19% (table 4).

Thus, according to all subjective and objective indicators as a result of treatment, improvement has come. Disability period is 14 days.

According to the totality of clinical and paraclinical data, the result of treatment was evaluated as “improvement” in the shortest possible time, without complications.

Example 2

Patient Sh-k A.G., born in 1981, treatment period from 05/28/10 - 06/06/10

Diagnosis: Acute laryngitis.

He complained of a lack of voice for 2 days, pain during phonation, shortness of breath, dry cough, sore throat.

From the anamnesis: 5 days ago I had SARS, I was worried about sore throat when swallowing, the temperature was up to 37.8C, chills, malaise.

Objectively: the larynx - the mucous membrane is hyperemic, the lumen of the larynx is moderately narrowed, the true vocal folds are pink, thickened, full closure.

Auditory assessment of a voice: a hoarse, hoarse, unbearable voice - a dysphonia of a pronounced degree (III), an aspiratory attack is a solid one.

Computer voice analysis: HNR signal-to-noise ratio was 18.0 dB, Jitter was 0.70, and Shimmer was 3.2.

Laryngostroboscopy - asynchronous oscillations, changes in the phase of opening and closing, changes in the amplitude and synchronism of oscillations, stroboscopic comfort are negative.

Clinical and laboratory data did not reveal significant changes

Ultrasound of the thyroid gland is the norm

Bacterial Analysis - S.Aureus

The treatment was prescribed according to the proposed method: Voice rest. General and local anti-inflammatory drug treatment in accordance with the standards. As well as the installation of staphylococcal bacteriophage 1 ml endolaryngially for 10 days.

The patient tolerated the prescribed treatment well. By day 4-5, he felt an improvement in his voice. Feeling good and good mood.

Upon completion of treatment, the voice improved. Auditory assessment of voice with (2) moderate degree of dysphonia normalizes to (0) i.e. to normal. The laryngoscopic picture improved overall from 2.0 to 0 points (Table 5).

Computer analysis of voice showed an improvement in terms of objective indicators: the signal-to-noise ratio HNR reached a value of more than 22.6 dB. The performance of Jitter and Shimmer decreased to optimal values: Jitter - below 0.4; Shimmer - below 2.4, which characterizes the dynamics of changes in the patient's condition as positive (table 6).

According to electronic laryngoscopy, the index of vibratory insufficiency from 1.4 to treatment is set to 1, which is normal (Table 7).

The dynamics of the blood test is positive: the number of leukocytes decreased by 15%, the number of lymphocytes - by 21% (table 8).

Thus, according to all subjective and objective indicators as a result of treatment, improvement has come. Disability periods of 10 days.

According to the totality of clinical and paraclinical data, the result of treatment is rated as “improvement” with minimal periods of disability.

A clinical study was performed on 104 patients. Two groups of patients were studied: patients with exacerbation of chronic laryngitis (47 people), the treatment of which was carried out according to the proposed method using antibiotics and bacteriophage therapy; and similar patients treated according to the traditional method in accordance with existing standards (21 people). The treatment contributed to the actual disappearance or a significant reduction in clinical manifestations during exacerbations of chronic laryngitis (Table 9).

In general, in the group of patients with chronic laryngitis, after treatment according to the claimed method, the number of patients without signs of active inflammation increased by more than 2 times. Confirmation of the improvement of the patient’s condition as a result of using the claimed method was the dynamics of computer voice analysis data (table 10). It was found that after treatment, the signal-to-noise ratio HNR increased from 18.07 to 20.05 dB (by 10%). The indicators Jitter and Shimmer decreased to optimal values: Jitter - from 0.71 to 0.53, Shimmer - from 6.08 to 4.24, which determines the positive dynamics of changes in the condition of patients.

Comparative results of using the proposed and traditional methods in the treatment of patients with exacerbation of chronic laryngitis are shown in Table 11. One of the most important advantages of the claimed method is that the likelihood of complications is reduced to 0.

The indicators of the blood test as a result of treatment by the claimed method decreased and entered the range of acceptable values (Table 12).

The treatment contributed to the actual disappearance of clinical manifestations in patients with acute laryngitis (table 13).

It was revealed that after treatment, the signal-to-noise ratio HNR increased from 18.05 to 19.97 (by 10%). The indicators Jitter and Shimmer decreased to optimal values: Jitter - from 0.99 to 0.41 (by 59%), Shimmer - from 6.19 to 3.31 (by 47%), which determines the positive dynamics of changes in the condition of patients ( Table 14).

The indicators of the blood test as a result of treatment according to the claimed method in patients with acute laryngitis decreased and fell into the range of acceptable values (Table 15).

Comparative results of using the proposed and traditional methods in the treatment of patients with acute laryngitis are shown in Table 16. One of the most important advantages of the claimed method is that the likelihood of complications is reduced to 0.

Comparing the results of treatment according to the claimed method with the treatment in accordance with the existing standard and with the treatment according to the prototype (Table 11 and Table 16), the shortest period of treatment in the claimed method was revealed, the clinical effect appeared after the first bacteriophage therapy procedure, a higher percentage of achievement of full recovery of function the vocal apparatus, as well as the absence of complications in the form of mucosal dysbiosis. All of the above indicates the advantages of the proposed method.

Information sources

1. Aznabaeva L.F., Dayanov A.N., Arefieva N.A., Sharipov R.A. A method for the treatment of chronic hyperplastic laryngitis. // pat. 2297847; publ. 04/27/2007

2. Babiyak V.I., Nakatis Ya.A. Clinical otorhinolaryngology // St. Petersburg: Hippocrates. - 2005 .-- 835 s.

3. Vasilenko Yu.S. Vote. Phoniatric aspects. // M.: Energoizdat. 2002 .-- 480 p.

4. Grigoryan S.S., Demchenko E.V., Ivanchenko G.F. A method for the treatment of chronic hyperplastic laryngitis. // pat. 2214249; publ. 10/20/2003.

5. Gusev M.V., Mineeva L.A. Microbiology. // M.: Publishing Center "Academy". - 2003 .-- 464 p.

6. Demchenko E.V., Ivanchenko G.F., Novakovsky D.L. Modern aspects of clinical and laboratory diagnosis and treatment of chronic hyperplastic laryngitis. // The quality of life. The medicine. - 2007. - p. 35-38.

7. Zaritsky L.A., Trinos V.A., Trinos L.A. Practical phoniatrics // Kiev. - 1984 .-- 165 s.

8. Kunelskaya N.L., Gurov A.V. Possibilities of using azalides in otorhinolaryngological practice. // Medical business. - 2010. - No. 4. - 7 p.

9. Lazareva E.B. Bacteriophages and pectins in the correction of disorders of microbiocenoses in purulent-inflammatory processes .: Abstract. diss. Doct. honey. sciences. // M. - 2007. - 18 p.

10. Osipenko E.V. Anti-inflammatory therapy in the treatment of patients with chronic laryngitis. // Bulletin of otorhinolaryngology. - 2009. - No. 4. - p. 63-65.

11. Ryabova M.A., Nemykh O.V. Chronic laryngitis: principles of pathogenetic treatment. // St. Petersburg. - 2010 .-- 139 p.

12. Svistushkin V.M. Empirical antibiotic therapy for acute inflammatory diseases of the upper respiratory tract. // Russian medical journal. - 2005. - t.13. - No. 4. - p. 57-61.

13. Soldatov I.B. Guide to otorhinolaryngology // M. - 1997. - 607 p. (prototype).

14. Sturov N.V., Ushkalova E.A. Efficacy and safety of azithromycin in the treatment of upper respiratory tract infections. // Farmateka - 2008. - No. 4. - p. 65-68.

15. Pozdeev O.K. Medical Microbiology. / Ed. V.I. Pokrovsky. - 4th ed., Erased. // - M.: GEOTAR-Media. - 2008 .-- 768 p.

16. Fattakhov B.T. The use of pyobacteriophage in the treatment and prevention of wound infection of the eye: Abstract. diss. Cand. honey. sciences. // Ufa., 1999. - 18.s.

17. Esposito S, Bosis S, Begliatti E, et al. Acute tonsillopharyngitis associated with atypical bacterial infection in children: natural history and impact of macrolide therapy. // Clin Infect Dis - 2006 .-- 43 (2) .: 206-09.

18. Sliwa-Dominiak J, Witkowska M, Deptula W. Biological alternatives to antibiotics Przegl Epidemiol. // 2010 - 64 (3): - 399-403. Review Polish

19. Uchiyama J, Takemura I, Hayashi I, Matsuzaki S, Satoh M, Ujihara T, Murakami M, Imajoh M, Sugai M, Daibata M. Characterization of lytic enzyme open reading frame 9 (ORF9) derived from Enterococcus faecalis bacteriophage phiEF24C. Appl Environ Microbiol. // 2011. - Jan; 77 (2): 580-5. Epub 2010 Nov 19.

20. Sunagar R, Patil SA, Chandrakanth RK. Res Microbiol. Bacteriophage therapy for Staphylococcus aureus bacteremia in streptozotocin-induced diabetic mice. // 2010 - Dec; 161 (10): 854-60. Epub 2010 Sep 22.

21. Daniel A, Euler C, Collin M, Chahales P, Gorelick KJ, Fischetti VA. Antimicrob Agents Chemother. / Synergism between a novel chimeric lysin and oxacillin protects against infection by methicillin-resistant Staphylococcus aureus. / 2010 - Apr; 54 (4): 1603-12. Epub 2010 Jan 19.

22. Klein GO. [Bacteriophage therapy can be the rescue when antibiotics no longer work]. Lakartidningen. // 2009 Sep 30-Oct 6; 106 (40): 2530-3. Review Swedish No abstract available.

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24. Miedzybrodzki R, Fortuna W, Weber-Dabrowska B, Gorski A. Phage therapy of staphylococcal infections (including MRSA) may be less expensive than antibiotic treatment. Postepy Hig Med Dosw (Online). // 2007. - Aug 3; 61: 461-5.

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application

Table 1

Dynamics of laryngoscopic picture data and auditory assessment of voice (in points)

table 2

Dynamics of computer voice analysis data

Table 3

Dynamics of electronic laryngostroboscopy data

Table 4

Dynamics of indicators of a general blood test

Table 5

Dynamics of laryngoscopic picture data and auditory assessment of voice

Table 6

Dynamics of computer voice analysis data

Table 7

Dynamics of electronic laryngostroboscopy data

Table 8

Dynamics of indicators of the general analysis of blood

Table 9

The dynamics of the severity of the main clinical manifestations of inflammatory diseases of the larynx during treatment according to the claimed method in points (n = 58),

where: * M ₁ - average; m ₁ is the error of the mean before treatment; M ₂ and m ₂ - after treatment, p - significance of differences at a statistical significance level of 95%

Table 10

The dynamics of the initially altered indicators of computer voice analysis during treatment according to the claimed method (n = 58)

Table 11

Comparative results of the use in the treatment of patients with exacerbation of chronic laryngitis of various methods of treatment,

where: * the significance of the difference between the claimed method and the compared group

Table 12

The dynamics of the initially altered blood parameters during treatment according to the claimed method in patients with chronic laryngitis (n = 47)

Table 13

The dynamics of the severity of the main clinical manifestations of inflammatory diseases of the larynx during treatment according to the claimed method in points (n = 23) (acute),

where: * M ₁ - average; m ₁ is the error of the mean before treatment; M ₂ and m ₂ - after treatment, p - significance of differences at a statistical significance level of 95%

Table 14

The dynamics of the initially altered indicators of computer voice analysis during treatment according to the claimed method (n = 23).

(sharp)

Table 15

The dynamics of the initially altered blood parameters during treatment according to the claimed method in patients with acute laryngitis (n = 23),

where: * - P is less than 0.05

Table 16

Comparative results of using the proposed and traditional methods in the treatment of patients with acute laryngitis,

where: * the significance of the difference between the claimed method and the compared group.

Table 1 Clinical sign Before treatment After treatment Hoarseness 3 0 Cough 2 0 The pharynx 3 0 True vocal folds 3 one Lumen of the larynx 2 one Mucous 3 one

table 2 Indicators Before treatment After treatment 1. HNR "o" 17.8 24.9 2. Jitter 1.48 0.33 3. Shimmer 7.35 0.84

Table 3 Indicators Before treatment After treatment 1. The presence of fluctuations one one 2. Change in the frequency of oscillations one one 3. The change in the amplitude of the oscillations one one 4. Change in closing phase one one 5. Change the opening phase 2 one IVN 1,2 one

Table 4 Indicators Before treatment After treatment 1. White blood cells 5,4 4.4 2. ESR 17 eighteen 3. Lymphocytes 33 32

Table 5 Clinical sign Before treatment After treatment Hoarseness 2 0 Cough one 0 The pharynx 3 0 True vocal folds 2 0 Lumen of the larynx 2 0 Mucous 2 0

Table 6 Indicators Before treatment After treatment 1. HNR "a" 18.0 26.6 2. Jitter 0.70 0.42 3. Shimmer 3.23 2.27

Table 7 Indicators Before treatment After treatment 1. The presence of fluctuations one one 2. Change in the frequency of oscillations one one 3. The change in the amplitude of the oscillations one one 4. Change in closing phase 2 one 5. Change the opening phase 2 one Vibrator Failure Index 1.4 one

Table 8 Indicators Before treatment After treatment 1. White blood cells 4.7 four 2. ESR 3 3 3. Lymphocytes 28 22

Table 9 Clinical sign Before treatment (M1 + M1) After treatment (M2 + m2) R Hoarseness 2.91 + _0.76 0.36 + _0.52 0,000 Cough 2.02 + _0.76 0.21 + _0.41 0,000 The pharynx 2.46 + _0.58 0.29 + _0.46 0,000 True vocal folds 2.38 + _0.49 0.51 + _ 0.50 0,000 Lumen of the larynx 2.38 + _0.57 0.29 + _0.46 0,000 Mucous 2.30 + _0.46 0.36 + _0.48 0,000

Table 10 Indicators Before treatment (M1 + M1) After treatment (M2 + m2) R NHR "and" 18.07 + _4.46 20.05 + _5.01 0,027 Jitter 0.71 + _0.57 0.53 + _0.41 0.005 Shimmer 6.08 + _3.82 4.24 + _3.35 0.003

Table 11 Indicators The claimed method (n = 47) Standard drug treatment (n = 21) Prototype Disability time, days, disease outcome 16.83 + 3.10 * 29.50 + 3.56 * 22-24 days * Complete relief of the disease,% 14 days 21 day 21 day Likelihood of complications 0 10% thirty%

Table 12 Indicators Before treatment After treatment R 1. White blood cells 6.97 + _1.67 5.54 + _1.75 0,000 2. ESR 10.02 + _6.7 8.61 + _6.59 0,000 3. Lymphocytes 34,084 + _7,46 30.87 + _7.90 0,000

Table 13 Clinical sign Before treatment (M1 + M1) After treatment (M2 + m2) R Hoarseness 2.75 + 0.85 0.29 + 0.46 0,000 Cough 2.04 + 0.75 0.25 + 0.44 0,000 The pharynx 2.80 + 0.51 0.17 + 0.38 0,000 True vocal folds 2.45 + 0.51 0.33 + 0.40 0,000 Lumen of the larynx 2.41 + 0.50 0.29 + 0.46 0,000 Mucous 2.79 + 0.41 0.37 + 0.57 0,000

Table 14 Indicators Before treatment (M1 + M1) After treatment (M2 + m2) R NHR (s) 18.05 + _6.20 19.97 + _4.17 0,301 Jitter (s) 0.99 + _1.99 0.41 + _0.24 0,078 Shimmer (s) 6.19 + _5.87 3.31 + _1.85 0.006

Table 15 Indicators Before treatment After treatment R 1. White blood cells 6.92 + _1.84 5.39 + _0.91 0,000 2. ESR 10.37 + _8.57 8.70 + _7.89 0.001 3. Lymphocytes 27.41 + _8.40 23.95 + _6.71 0,000

Table 16 Indicators The claimed method (n = 23) Standard drug treatment (n = 13) Prototype Disability time, days, disease outcome 9 twenty fourteen Complete relief of the disease,% 75 twenty* 70 Likelihood of complications 0 thirty% 10%

Claims (1)

1. A method of treating acute and exacerbation of chronic laryngitis by conducting specific antibiotic therapy per os, characterized in that from 3-5 days from the onset of the disease, microflora is additionally examined with subsequent instillations of specific, according to the results of the study, bacteriophages into the larynx in an amount of 0.5 -1.0 ml for acute laryngitis for 7-10 days, and for exacerbations for 10-14 days.
2. The method according to claim 1, characterized in that in complicated cases, a specific bacteriophage per os is additionally administered per 1 tbsp. 3 times a day for 2 weeks.