4 Macrolide-Resistant Mycoplasma Pneumonia in the Management of Chronic Nonspecific Pharyngitis Atypical pathogens are known to cause a disproportionate disease burden in children and adolescents. Atypical pneumonia is most commonly caused by Mycoplasma pneumoniae, Legionella pneumoniae, Chlamydophila pneumoniae, Coxiella brunette, and Francisella tularensis. The intracellular nature of the atypical pathogens makes it difficult to culture under standard methods, and hence, they are not apparent on a Gram stain. Classic diagnostic findings of atypical pneumonia include patchy infiltrates (sometimes distributed bilaterally) and interstitial patterns. Mycoplasma pneumonia (MP) has become a leading cause of pediatric community-acquired pneumonia (CAP). It is responsible for 25% of all CAP cases. The clinical symptoms are usually mild and selflimiting in adults, but the infection can occasionally Aim To evaluate the efficacy of Septilin in chronic nonspecific pharyngitis, in comparison with Actifed Materials and Methods This randomized, double-blinded, placebo-controlled clinical trial included 50 outpatients with chronic nonspecific pharyngitis (both sexes; age, 18–49 y). The enrolled patients were divided into 2 groups of 25 each, ensuring equal distribution based on age, sex, and symptom similarity. The complete medical history and physical andENTexamination data of the patientswere recorded before starting the therapy. Group 1 patients received 2 tablets of Septilin, TID, and group 2 received 2 tablets of Actifed, BID. The duration of therapy was 3 weeks in both the groups. At the end of the treatment period, the outcomes of the treatment in both the groups were evaluated and compared, and the response was categorized as Good, Satisfactory, Poor, and No Response. Results In the posttreatment assessment, a good relief in persistent sore throat was observed in 70% of the patients in group 1 and in 52% of the patients in group 2. The response to halitosis was significantly better in group 1 (57%) than in group 2 (22%). The response to congestion of the mucosa was also better in group 1 (88%) than in group 2 (76%). Response with respect to other symptoms (eg, discomfort in swallowing) and hypertrophy of lymphoid tissue was marginally better in group 1. Asuccessful outcome was seen in 68% of the patients in group 1 in comparison with 40% in group 2 patients (Tables 1 and 2). No Septilin, a phytopharmaceutical formulation, is recommended for the treatment and management of various infections and to prevent their recurrence. The immunomodulatory action of Septilin potentiates the immune responses of the body. Septilin also reduces inflammation and allergy and corrects the underlying pathologic features associated with recurrent infections. When coprescribed with antibiotics, Septilin ensures faster recovery and prevents recurrence. Pharmacologic Actions z z Immunomodulatory action z z Antioxidant action z z Anti-inflammatory action z z Antimicrobial action Indications z z As an immunomodulator in the management of: – RT and ENT infections (tonsillitis, pharyngitis, bronchitis, sinusitis, and otitis media) – Skin and soft tissue infections – Dental and periodontal infections – Ophthalmic infections – Bone and joint infections – Urinary tract infections z z For early recovery in postoperative conditions z z To reduce recurrence in infection-prone individuals z z As an adjuvant to anti-infective therapy z z Resistance to antibiotic therapy Sources: Stamm DR, Stankewicz HA. Atypical Bacterial Pneumonia. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2021. Loconsole D, et al. Infect Dis Rep. 2021;13(3):811–820. cause extra-respiratory manifestations such as skin lesions, hematologic disorders, and cardiovascular and neurologic diseases. Macrolides, tetracyclines, and fluoroquinolones are considered the first choice of treatment for MP in adults, and only macrolides are recommended for children. However, inappropriate use or overuse of macrolides has led to a worldwide occurrence of macrolide-resistant MP (MR-MP) strains. MR-MP is found more commonly in children than in adults, and the infection leads to persistent symptoms of fever and cough and a prolonged carriage. The emergence of MR-MP has raised the global antimicrobial resistance threat, with reports of resistance rates of 80% to 90% in Asia. Further studies on genome sequencing are required to decode the genome of MR-MP strains to understand better the mechanisms underlying their resistance. Ayurveda defines Prana as the life force that is necessary to carry out the vital functions of life. The Prana Vayu is responsible for respiration in the human body. The channels or tracts (Srotas) in which Prana Vayu flows are called Pranavaha Srotas, and this has been correlated to the respiratory system. Pranavaha Srotas structurally and functionally combine various organs such as naasa (the nostrils), hrudaya (the chest cavity and the cardiac region), mahasrotas pranavahani Respiratory Health: An Ayurvedic Perspective dhamanis (the lungs and the arteries), and the respiratory center in the brain. Any imbalance in the doshas governing the normal functions of Pranavaha Srotas leads to pranavaha srota dusti (vitiation). The major doshas related to the respiratory system are Vata and Kapha. Symptoms of vitiation of Pranavaha Srotas not only include the respiratory system but also involve the circulatory and central nervous systems. The characteristic manifestations of the vitiation of Pranavaha Srotas are atisristam-atibaddham (too long or too restricted respiration), kupita (disturbed pattern of respiration), alpa-alpam (shallow or frequent respiration), and sashabdam sashoolam (respiration associated with altered sound and pain). Kaasa (cough) is a very common presentation. Based on the dosha involved, it can be dry or productive. Table 1. Posttreatment Clinical Assessment Symptom Group 1 Group 2 Persistent Sore Throat 7 11 Discomfort in Swallowing 9 12 Halitosis 3 7 Hypertrophy of Lymphoid Tissue 9 11 Congestion of Mucosa 9 3 Table 2. Posttreatment Clinical Score Assessment Criteria Score Group 1 Group 2 No Symptoms (Good) 9 (36%) 4 (16%) Symptoms Present but Not Troublesome (Satisfactory) 8 (32%) 6 (24%) Symptoms Troublesome, but Not Interfering With Normal Activities (Poor) 2 (8%) 8 (32%) Symptoms Interfering With Normal Activities (No Response) 6 (24%) 7 (28%) s with tagline Curved h adverse effects were observed with the use of Septilin during the study. However, 9 patients on Actifed complained of significant sedation. Conclusion Septilin, a phytopharmaceutical formulation from Himalaya Wellness Company, has distinct immunomodulatory and anti-inflammatory properties that potentiate the nonspecific immune responses of the body, reduce inflammation and allergy, and correct the underlying pathologic features associated with recurrent infections. Septilin does not induce sedation, and thus, could be a useful alternative in ambulatory patients suffering from chronic nonspecific pharyngitis. An excerpt from the clinical study conducted by Nehru V published in the journal The Indian Practitioner is featured here. Brand na es with tagli e Open type Curved Builds the body’s own defense mechanism Evecare® Ensures complete uterine care (CAPSULE, SYRUP) Septilin® (SYRUP, TABLET)
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