Chronic tonsillitis and pharyngitis
Chronic inflammatory changes of tonsils and pharyngeal mucosa with periodic exacerbations. International guidelines (IDSA, NICE NG84) emphasise systemic antibiotics only for documented streptococcal infection. Oral 'immunomodulators' are absent from overseas recommendations.
ICD-10 J31.22 drugs
Also known as: Chronic tonsillitis, Chronic pharyngitis
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- Dα-Glutamyl-L-tryptophanNot recommended · Other immunostimulants (synthetic peptides, local classification)For chronic tonsillitis and pharyngitis, Thymogen is absent from AAO-HNS and ESPO ENT guidelines. Evidence-based management: hygiene, antibiotic therapy for purulent flares on indication, and tonsillectomy in confirmed recurrences by Paradise criteria.
- FImudon (polyvalent bacterial lysate)Not recommended · Other oral cavity preparations (local classification)International guidelines for chronic tonsillitis and pharyngitis (IDSA 2012, NICE NG84, CKS) do not include Imudon. Documented streptococcal infection is treated with antibiotics. Viral and mixed forms are managed symptomatically. Oral bacterial lysates are not used by the international medical community.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit