Oropharyngeal microbiota profi ling in chronic tonsillitis patients receiving polyvalent pyobacteriophage: A non-randomised experimental clinical trial

Background. Recent years have witnessed a 1.5–1.8-fold growth of chronic palatine tonsillitis. Choosing optimal treatment remains relevant in this illness despite ample research and improvement in therapy and diagnosis.

Objectives. An analysis of oropharyngeal microflora in chronic tonsillitis patients receiving a polyvalent pyobacteriophage treatment.

Methods. A total of 126 patients diagnosed with compensated chronic tonsillitis were followed up over 2018–2021. Qualitative and quantitative traits of oropharyngeal microflora have been assessed at baseline, immediately upon completion and past 3 months of treatment. The patients were separated between two cohorts: the main one (n = 65) had palatine tonsil lacunae irrigation with a Tonsillor MM unit and received polyvalent pyobacteriophage, while the comparison cohort (n = 61) only had palatine tonsil lacunae sanitation with Tonsillor MM. The trial included a control healthy volunteers cohort. Pearson’s chi-square method was used for statistical analyses with the SPSS 23 software. Statistical significance was obtained at p < 0.05.

Results. Quantitative comparisons of microbiotic strain persistence in tonsillar mucosa (isolation rate, microbial colonisation density) showed a significant prevalence of enterobacterial staphylococci and ß-haemolytic streptococci, Gram-negative anaerobic bacteria and fungi in chronic tonsillitis patients compared to the control cohort (p < 0.05). Therapy positively impacted microbiota vs. control, but the best effect was observed with polyvalent pyobacteriophage. Microbiological assays in dynamic patient follow-up demonstrated stability of the results attained. The Tonsillor MM sanitation cohort revealed a 2–3 degree dysbiosis in 47.5% (29) patients in 3 months, while the polyvalent pyobacteriophage cohort only had 7.7% (5) such patients (p < 0.01).

Conclusion. The trial demonstrates efficacy and relevance of pyobacteriophage treatment in chronic tonsillitis, primarily at the microenvironmental level.