Lactoferrin versus Long-Acting Penicillin in Reducing Elevated Anti-Streptolysin O Titer in Cases of Tonsillopharyngitis

Abstract

Aida Ahmed Abdelmaksoud,1 Asmaa Nafady,2 Shamardan Ezzeldin Sayed Bazeed,3 Mahmoud Khalefa,4 Mahmoud K Elsamman,5 Mennatallah Ali Abdelrhman Sayed,6 Heba Mohammad Qubaisy,7 Ali A Ghweil,3 Zaki F Aref1,8 1ENT, South Valley University, Qena, Egypt; 2Clinical and Chemical Pathology, South Valley University, Qena, Egypt; 3Tropical Medicine and Gastroenterology, South Valley University, Qena, Egypt; 4ENT, Faculty of Medicine, Aswan University, Aswan, Egypt; 5Internal Medicine, Sohag University, Sohag, Egypt; 6King Salman International University, Sharm ElSheikh, Egypt; 7Pediatrics, South Valley University, Qena, Egypt; 8Department and Institution, ENT Department, Clinical and Chemical Chemistry Department Faculty of Medicine, South Valley University, Qena, EgyptCorrespondence: Asmaa Nafady, Clinical and Chemical Pathology, Qena Faculty of Medicine, South Valley University, Qena, Egypt, Tel [phone], Fax [phone], Email [email protected]; [email protected]: Beta-Hemolytic streptococci are the most frequent bacteria causing tonsillitis. Lactoferrin may play a role in the treatment of chronic tonsillitis due to its direct antimicrobial activity.Objective: To assess the possible role of lactoferrin in reduction of raised serum Anti-Streptolysin O Titer (ASOT) in cases of chronic tonsillopharyngitis in comparison to long acting penicillin.Methods: This study included 117 children with tonsillopharyngitis with high ASOT randomly divided into three groups; group 1 treated with lactoferrin, group 2 treated with long acting penicillin and group 3 treated with both drugs. For all patients ASOT was measured after three and six months of starting treatment.Results: This study included 60 males and 57 females with the mean age (8.5 ± 2.4). There is statistically significant reduction in ASOT in all groups after three months of treatment. ASOT after 3 months was significantly lower in group1 (370± 440) and group 3 (350± 450) in comparison to group 2 (420± 560) with p value 0.02, 0.004, respectively, with no significant difference in comparing group 1 to group 3 p value 0.4. Also, ASO titre after 6 months was significantly lower in group1 (350± 420) and group 3 (340± 440) in comparison to group 2 (420± 550) with p value 0.02, 0.007, respectively, with no significant difference in comparing group 1 to group 3 p value 0.5. In comparing ASOT at three months and six months of treatment in the three studied groups; it decreased by 2% in group 1, and 1.6% in group 3 and no change in group 2.Conclusion: Lactoferrin alone or in combination with long acting penicillin is safe and more effective than long acting penicillin alone in reducing ASOT. Treatment for six months with lactoferrin alone or in combination with long acting penicillin could offer a better response.Keywords: lactoferrin, long-acting penicillin, anti-streptolysin O titer, tonsillopharyngitis

Keywords

• lactoferrin
• long-acting penicillin
• anti-streptolysin o titer
• tonsillopharyngitis