Topical iota carrageenan in acute pharyngitis – a randomized controlled study.

Introduction:The commonly found upper respiratory tract (URT) affections are initially viral in aetiology.The viral pharyngitis may lead to complications and subsequent significant increase in morbidity.Iota-carrageenan is a naturally occurring seaweed that was found accidently reducing viral replication during experimental studies.This property of I-C is used in cases of acute URTI to reduce viral load and thereby alleviating the symptoms.Iota-carrageenan is found efficacious against several respiratory viruses, as demonstrated by three independent clinical trials.In this study the Iota-carrageenan in lozenge form was used to find out its effectiveness in symptomatic cases of acute viral pharyngitis.Aim: To evaluate antiviral property of iota carrageen as a lozenge in cases of acute viral pharyngitis Methodology: This study was undertaken at E.N.T department at tertiary care teaching hospital.All enrolled cases were randomized in group-I and II that received iota carrageenan as the interventional agent and placebo respectively.Jackson's total symptom score (TSS) was employed to evaluate the symptoms both before and after the therapy.Every individual patient was asked to maintain symptom score diary at home and present it during periodic follow up.Results: The baseline TSS0 of the participants in both therapy group were comparable (mean TSS was 6.75 for carrageenan group and 6.79 for control group).At baseline investigation amongst all patients of both groups; cases having human rhinovirus (HRV) were 53(54.1%)and 54(55.7%)out of total 180 patients of both group I and II respectively.TSS2-4 was 5.68 0.35 (p=0.0895) and 6.83 0.35 for group I and II respectively, after unblinding some exploratory studies through following parameters: TSS average over a period of days 1-4 (TSS1-4); change in TSS1-4 in comparison to baseline (TSS1-4, rel); and treatment differences favouring I-C (p=0.0364,p=0.0495, and p=0.0421, respectively).There was a propensity towards a higher decrease in the amount of virus on days 3 or 4 for individuals with a discernible rhinovirus at baseline (p=0.0958;I-C: 90.2% decrease in the number of viruses; placebo 72.0%).For every therapy the frequency of adverse events was the same, and they were well tolerated.Conclusion: Amongst both groups, the group I receiving the I-C (90.2% cases) did show significant improvement of total symptom scores (TSS) in cases of acute viral pharyngitis.However, in group II (72.0%cases) who received placebo did not substantiate similarly statistically.Further, all these cases of group I improved (90.2%) within 4 days of start of treatment, as against in cases of group II (72.0%cases) showed improvement during first 4 days.