fusafungin and Laryngitis

This is an update of the original review published in 2005. Acute laryngitis is a common illness worldwide. Diagnosis is often made by case history alone and treatment often targets symptoms.. To assess the effectiveness and safety of different antibiotic therapies in adults with acute laryngitis. A secondary objective was to report the rates of adverse events associated with these treatments.. We searched CENTRAL (2014, Issue 11), MEDLINE (January 1966 to November week 3, 2014), EMBASE (1974 to December 2014), LILACS (1982 to December 2014) and BIOSIS (1980 to December 2014).. Randomised controlled trials (RCTs) comparing any antibiotic therapy with placebo for acute laryngitis. The main outcome was objective voice scores.. Two review authors independently extracted and synthesised data.. We included three RCTs (351 participants) that had moderate to high risk of bias. The quality of the evidence was very low for all outcomes. We downgraded the studies because of limitations in study design or execution (risk of bias), imprecision and inconsistency of results. We included a new trial presented only as a conference abstract in this update.In one study of acute laryngitis in adults, 100 participants were randomised to receive penicillin V (800 mg twice daily for five days) or an identical placebo. A recording of each patient reading a standardised text was made at the first visit, during re-examination after one and two weeks, and at follow-up after two to six months. No significant differences were found between the groups. The trial also measured symptoms reported by participants and found no significant differences.One study investigated erythromycin for acute laryngitis in 106 adults. The mean objective voice scores measured at the first visit, at re-examination after one and two weeks, and at follow-up after two to six months did not significantly differ between the groups. At one week there were significant beneficial differences in the severity of reported vocal symptoms (slight, moderate and severe) as judged by participants (P value = 0.042). However, the rates of participants having improved voice disturbance (subjective symptoms) at one and two weeks were not significantly different among groups. Comparing erythromycin and placebo groups on the rate of persistence of cough at two weeks, the risk ratio (RR) was 0.38 (95% confidence interval (CI) 0.15 to 0.97, P value = 0.04) and the number needed to treat for an additional beneficial outcome (NNTB) was 5.87 (95% CI 3.09 to 65.55). We calculated a RR of 0.64 (95% CI 0.46 to 0.90, P value = 0.034) and a NNTB of 3.76 (95% CI 2.27 to 13.52; P value = 0.01) for the subjective voice scores at one week.A third trial from Russia included 145 patients with acute laryngitis symptoms. Participants were randomised to three treatment groups: Group 1: seven-day course of fusafungine (six times a day by inhalation); Group 2: seven-day course of fusafungine (six times a day by inhalation) plus clarithromycin (250 mg twice daily for seven days); Group 3: no treatment. Clinical cure rates were measured at days 5 ± 1, 8 ± 1 and 28 ± 2. The authors reported significant differences in the rates of clinical cure at day 5 ± 1 favouring fusafungine (one trial; 93 participants; RR 1.50, 95% CI 1.02 to 2.20. Antibiotics do not appear to be effective in treating acute laryngitis when assessing objective outcomes. They appear to be beneficial for some subjective outcomes. Erythromycin could reduce voice disturbance at one week and cough at two weeks when measured subjectively. Fusafungine could increase the cure rate at day five. The included RCTs had important methodological problems and these modest benefits from antibiotics may not outweigh their cost, adverse effects or negative consequences for antibiotic resistance patterns.

Topics: Acute Disease; Adult; Anti-Bacterial Agents; Clarithromycin; Depsipeptides; Erythromycin; Fusarium; Humans; Laryngitis; Penicillin V; Randomized Controlled Trials as Topic

Four-hundred and eighty-four patients with acute laryngitis were examined before and after treatment with fusafungin under phase IV conditions. After one week of therapy such complaints as hoarseness, sore throat and difficulties in swallowing were improved in about 90% of the patients, while the leading complaint of "hoarseness" had disappeared in 60%. Inflammatory findings, documented by a physician, showed comparable results. An analysis of subgroups (ineffectively treated patients and patients with long-lasting symptoms and complaints) shows that fusafungin was effective therapeutically for treating for acute laryngitis. This study also shows that the generally accepted high rate of spontaneous recovery does not exist.

Topics: Acute Disease; Administration, Inhalation; Adolescent; Adult; Aerosols; Anti-Bacterial Agents; Depsipeptides; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Fusarium; Humans; Laryngitis; Male; Middle Aged

An open clinical trial of Locabiotal, in which the antibiotic, fusafungine, is presented in a micronized aerosol was performed in general practice. One hundred and ten patients suffering from upper respiratory infections without associated hyperpyrexia or toxic symptoms were treated for 7 days. There was a marked improvement in the symptoms rated during the first 48 hours. After the full course of treatment 37 patients regarded its effect as excellent and 48 as good.

Topics: Adolescent; Adult; Aerosols; Aged; Anti-Bacterial Agents; Child; Child, Preschool; Common Cold; Depsipeptides; Female; Humans; Laryngitis; Male; Middle Aged; Pharyngitis; Respiratory Tract Infections; Rhinitis