PLACE OF MUKOACTIVE THERAPY OF RINOSINUSITIS IN INTERNATIONAL AND RUSSIAN GUIDELINES

Excessive accumulation of mucous secretions in the nasal cavity and paranasal sinuses is key drivers in the pathogenesis  of rhinosinusitis. Mucoactive drugs are actively used to combat this phenomenon. Mucoactive drugs promote mucosal secretion clearance due to increase of ciliary beat frequency in ciliated epithelium and decrease in the viscosity of secretion by means of hydrolysis of disulfide bonds and increased mucus moisture. The lack of clinical trials that meet the requirements of evidencebased medicine did not allow to include this class of drugs in the official guidelines for a long time.  However, thanks to the latest results, phytopreparations including a mucoactive plant preparation Myrtol standardized have been introduced into the European position paper on rhinosinusitis and nasal polyps (EPOS 2012). A large randomized double-blind multicenter study involving more than 300 patients with acute rhinosinusitis showed that administration of Mirtol standardized facilitates acceleration of the regression of the disease symptoms, reduces the need for antibiotic therapy and reduces the period of disability as compared to taking placebo. The results of this and other clinical studies allowed Myrtol to take a rightful place in the international and domestic guidelines.