PDT, an Adjuvant Therapy to Antibiotic Failure in Streptococcal Tonsillopharyngitis
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 6, Issue 4
Abstract
In the last decades, the emergence and spread of antimicrobial resistance bacteria has been viewed. Multidrug resistant bacteria are currently considered agents of worldwide emerging diseases and thus an important public health problem. Coordinated efforts to develop new therapeutic strategies are necessary. Photodynamic therapy (PDT) is a therapeutic modality based in photochemical and photophysical processes. PDT has been shown to be effective in bacterial lysis and safe in oral cavity for oral disinfection [1,2]. We report a clinical case of recurrent pharyngotonsillitis (FT) in presence of microorganisms that did not respond to antibiotic treatment. The PDT was applied in three sessions in two steps: application of pharmaceutical formulations containing 0.75 mg/mL curcumin and illumination at 450 nm and 6.57 J/cm2. It was concluded that the PDT may be used as treatment in cases of antibiotic failure. In addition, periodically the PDT may be applied in case of recurrent pharyngitis. he patient’s response to therapy may not be immediate1. It is often interpreted as a failure of medical treatment. This response should be considered due to antibiotics have the late effects[2]. Immunocompetent patients have shown a satisfactory clinical response of 48 hours in infectious processes. A patient can respond immunologically to PT maintaining its febrile state[3]. The clinical approach to these situations has included the search for a surgical alternatives such as abscess drainage and tonsil removal.Incorrect prescription of antibiotics, inadequate antibiotic action and patient immunosuppression are indicated factors as treatment failures in PT.The standard treatment for streptococcal tonsillopharyngitis has been penicillin since the 1950s. The rate of failure of penicillin has been approximately 30%. Resistant bacterial strains are a treatment failure factor in patients with streptococcal PT.PDT occurs due to photochemical reaction which three acting factors4. The agents are: a photosensitive molecule; activating light of photosensitizer (PS) and oxygen in the environment.Two steps are necessary for occur PDT: a) PS accumulates in the cells after its topical or systemic administration; b) The sensitized bacterium is exposed to light at wavelength coincident to absorption spectrum of PS. The action of light and photosensitive molecule triggers two different reactions. First, there is an electronic excitation of PS by light and then two reaction mechanisms occur from the excited state. In this study, the efficacy of PDT for recurrent treatment as a adjuvant treatment after antibiotic failures was verified. We describe a clinical case of chronic PT treated with PDT.
Authors and Affiliations
Kate Cristina Blanco, Natalia Mayumi Inada, Vanderlei Salvador Bagnato
Keywords
Related Articles
- EP ID EP592366
- DOI 10.26717/BJSTR.2018.06.001377
- Views 132
- Downloads 0
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