• The role of OM-85 BV (Broncho-Vaxom) in preventing recurrent acute tonsillitis in children 
en To content

The role of OM-85 BV (Broncho-Vaxom) in preventing recurrent acute tonsillitis in children 

SOVREMENNAYA PEDIATRIYA.2015.6(70):25-29 
 

The role of OM-85 BV (Broncho-Vaxom) in preventing recurrent acute tonsillitis in children 
 

Bitar M. A., Saade R.

Department of Otolaryngology Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon

Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon 
 

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% and total: by >50%). Patients showing response to Broncho-Vaxom were further followed until studyend 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. 
 

Key words: Bacterial lysates Immunomodulators Immunostimulants Recurrent tonsillitis. 

References

1. Georgalas C, Tolley N, Kanagalingam J. 2004. Measuring quality of life in children with adenotonsillar disease with the Child Health Questionnaire: a first U.K. study. Laryngoscope. 114: 1849—1855. http://dx.doi.org/10.1097/00005537-200410000-00032; PMid:15454784

2. Burton MJ, Glasziou PP, 2009. Tonsillectomy or adeno-tonsillectomy versus nonsurgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst. Rev. CD001802. PMid:19160201

3. Georgalas C.C., Tolley N.S., Narula A. Tonsillitis. Clin Evid. 2009. Online.

4. Little P, Gould C, Williamson I, Warner G, Gantley M, Kinmonth AL. 1997. Reattendance and complications in a randomised trial of prescribing strategies for sore throat: the medicalising effect of prescribing antibiotics. BMJ. 315: 350—352. http://dx.doi.org/10.1136/bmj.315.7104.350; PMid:9270458 PMCid:PMC2127265

5. Emmerich B, Emslander HP, Milatovic D, Hallek M, Pachmann K. 1990. Effects of a bacterial extract on local immunity of the lung in patients with chronic bronchitis. Lung. 168. Suppl: 726—731. http://dx.doi.org/10.1007/BF02718200; PMid:2117184

6. Schaad UB. 2010. OM-85 BV, an immunostimulant in pediatric recurrent respiratory tract infections: a systematic review. World J Pediatr. 6: 5—12. http://dx.doi.org/10.1007/s12519-010-0001-x; PMid:20143206

7. Rozy A, Chorostowska-Wynimko J. 2008. Bacterial immunostim ulants — mechanism of action and clinical application in respiratory diseases. Pneumonol Alergol Pol. 76: 353—359. PMid:19003766

8. Bailey BJ, Johnson JT, Newlands SD. 2006. Head and neck surgery — otolaryngology. 4th ed. Lippincott Williams & Wilkins, Philadelphia, PA.

9. Schaad UB, Mutterlein R, Goffin H. 2002. Immunostimulation with OM-85 in children with recurrent infections of the upper respiratory tract: a double_blind, placebocontrolled multicenter study. Chest. 122: 2042—2049. http://dx.doi.org/10.1378/chest.122.6.2042; PMid:12475845

10. Jara-Perez JV, Berber A. 2000. Primary prevention of acute respiratory tract infections in children using a bacterial immunostimulant: a double-masked, placebo-controlled clinical trial. Clin Ther. 22: 748—759. http://dx.doi.org/10.1016/S0149-2918(00)90008-0

11. Gutierrez-Tarango MD, Berber A. 2001. Safety and efficacy of two courses of OM_85 BV in the prevention of respiratory tract infections in children during 12 months. Chest. 119: 1742—1748. http://dx.doi.org/10.1378/chest.119.6.1742; PMid:11399700

12. Paupe J. 1991. Immunotherapy with an oral bacterial extract (OM-85 BV) for upper respiratory infections. Respiration. 58: 150—154. http://dx.doi.org/10.1159/000195916; PMid:1745846

13. Schaad UB, Farine JC, Fux T. 1986. Prospective placebo-controlled double-blind study using a bacterial lysate in infections of the respiratory tract and ENT region in children. Helv Paediatr Acta. 41: 7—17. PMid:3755127

14. Collet JP, Ducruet T, Kramer MS, Haggerty J, Floret D, Chomel JJ et al. 1993. Stimulation of nonspecific immunity to reduce the risk of recurrent infections in children attending day-care centers. The Epicreche Research Group. Pediatr Infect Dis J. 12: 648—652. http://dx.doi.org/10.1097/00006454-199308000-00005; PMid:8414777

15. Pessey JJ, Megas F, Arnould B, Baron-Papillon F. 2003. Prevention of recurrent rhinopharyngitis in atrisk children in France: a cost-effectiveness model for a nonspecific immunostimulating bacterial extract (OM-85 BV). Pharmacoeconomics. 21: 1053—1068. http://dx.doi.org/10.2165/00019053-200321140-00005; PMid:13129417

16. DeBaets F, Kint J, Pauwels R, Leroy J. 1992. IgG subclass deficiency in children with recurrent bronchitis. Eur J Pediatr. 151: 274—278. http://dx.doi.org/10.1007/BF02072228; PMid:1499580

17. Koo CY, Eisenhut M. 2011. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. Can inflammatory markers distinguish streptococcal from viral tonsillitis? Emerg Med J. 28: 715—717. http://dx.doi.org/10.1136/emermed-2011-200396http://dx.doi.org/10.1136/emj.2010.099531; PMid:21788241