The role of OM-85 BV (Broncho-Vaxom) in preventing recurrent acute tonsillitis in children
The role of OM-85 BV (Broncho-Vaxom) in preventing recurrent acute tonsillitis in children
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DOI：
10.1016/j.ijporl.2013.01.009
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发表时间：
2013-05-01
影响因子：
1.5
通讯作者：
Saade, Rami
中科院分区：
文献类型：
--
作者：
Bitar, Mohamed A.;Saade, Rami
目的：评价免疫刺激剂(细菌裂解物)Broncho-Vaxom治疗儿童复发性急性扁桃体炎的疗效。方法：对177例确诊为复发性急性扁桃体炎的儿童进行5年回顾性队列研究。检索患者陈述时的人口统计学和实验室研究。对于接受Broncho-Vaxom治疗的患者，我们将反应定义为治疗3个月后急性扁桃体炎发作频率的下降(部分：下降50%)。对对Broncho-Vaxom有反应的患者进行进一步随访，直到研究结束或需要进行扁桃体切除术。结果：患者的中位年龄为4.5岁(范围1-15岁)，其中63.8%为男性。131例(74%)患者接受Broncho-Vaxom初治，99例(75.6%)有效(51.2%)，部分有效(24.4%)。血沉正常是完全缓解的唯一预测因素(OR：3.53，95%CI：1.03~12.07)，血沉正常(OR：7.15倍，95%CI：1.18~43.39)和正常C反应蛋白(OR：12.66，95%CI：1.43~111.86)是完全缓解的独立预测因素。完全缓解者无一例长期行扁桃体切除术，部分缓解者34.4%需再次行扁桃体切除术(中位随访时间：9个月)。结论：接受Broncho-Vaxom治疗复发性急性扁桃体炎的患儿中，有相当比例的患者短期内发作次数减少，长期随访时仅有极少数患者最终需要行扁桃体切除术。(C)2013爱思唯尔爱尔兰有限公司。保留所有权利。
Objective: To evaluate the efficacy of an immunostimulant (bacterial lysate) Broncho-Vaxom in the management of children with recurrent acute tonsillitis.Methods: A 5-year retrospective cohort study of 177 children presenting with a diagnosis of recurrent acute tonsillitis. Patients' demographics and laboratory studies at presentation were retrieved. For patients given Broncho-Vaxom, we defined response as a decrease in the frequency of acute tonsillitis episodes after 3 months of therapy (partial: by 50%). Patients showing response to Broncho-Vaxom were further followed until study-end or need for tonsillectomy.Results: The median age of patients was 4.5 years (range: 1-15 years) with 63.8% being males. 131 (74%) patients received Broncho-Vaxom as initial therapy, and 99 (75.6%) showed response (51.2% total and 24.4% partial response). A normal ESR level was the only predictor of total compared with no response (OR: 3.53,95% CI: 1.03-12.07); while both normal ESR (OR: 7.15-times, 95% CI: 1.18-43.39) and normal CRP (OR: 12.66, 95% CI: 1.43-111.86) levels were independent predictors of total over partial response. None of the patients showing total response required tonsillectomy on long-term follow up while in those with partial response 34.4% required subsequent tonsillectomy (median follow-up: 9 months).Conclusions: A considerable proportion of children receiving Broncho-Vaxom for recurrent acute tonsillitis show a decrease in the frequency of episodes in the short term, and very few patients eventually require tonsillectomy on long-term follow up. (C) 2013 Elsevier Ireland Ltd. All rights reserved.