Effects of Various Local Antibacterial Preparations on Bacterial Density in Pharyngeal and Tonsillar Mucosa of Patients with Acute Pharyngitis

<i>Background and Objectives</i>: Upper respiratory tract infections are one of the most common reasons for outpatient admission. Acute pharyngitis is typically caused by viruses and is self-limiting but in up to 30% of cases, secondary bacterial infection may occur, requiring antibacterial treatment. In the face of growing antibacterial resistance due to inappropriate systemic antibiotic use, different topical therapy would have benefits. The objective of this study was to compare changes in throat and tonsillar mucous membrane bacterial density in patients with acute pharyngitis after a single exposure to a local antibacterial agent presented in different pharmaceutical forms-medicated lozenge, throat spray, or a solution for gargling. <i>Materials and Methods</i>: This was a non-interventional observational study that involved 90 adult outpatients with acute pharyngitis. Patients were prescribed to one of three options: medicated lozenges (containing dequalinium chloride and cinchocaine hydrochloride)-Treatment A; throat spray (containing streptocide soluble and norsulfazol-sodium)-Treatment B; or a powder, Furasol^® 100 mg (containing furagin soluble), for use as an external gargling solution-Treatment C. Throat swab culture was collected before and 20 min after the single exposure to the medication. Microbial testing was performed using a semi-quantitative quadrant streak plate method to assess bacterial density before and after exposure. <i>Results</i>: Four pathogenic agents were isolated from the swabs, with <i>Staphylococcus aureus</i> being the most prevalent. Overall, a reduction in post-exposure bacterial growth intensity was observed in 84.6% of the samples after Treatment C exposure, with a statistically significant difference from both Treatment B (57.1%, <i>p</i> < 0.05) and Treatment A (10%, <i>p</i> < 0.05). The difference was also significant between Treatment A and Treatment B. <i>Conclusions</i>: The findings showed that the throat gargling solution had more impact on mucous bacterial load compared to the throat spray and medicated lozenges in the patients with acute pharyngitis. Further research should address the effects of different pharmaceutical forms of the same antibacterial agent, where available.