Abstract

Background: Recurrent tonsillitis presents a significant clinical challenge, often requiring surgical intervention when antibiotic therapy fails. Antimicrobial photodynamic therapy (aPDT) has emerged as a promising non-invasive alternative, offering effective microbial load reduction and symptomatic relief without contributing to antibiotic resistance. Methods: assessed the efficacy of aPDT in patients over 18 years old diagnosed with pharyngotonsillitis caused by Streptococcus beta-hemolyticus (SBH). Participants were divided into three groups [1], aPDT alone [2], aPDT combined with anti-inflammatory drugs, and [3], aPDT combined with antibiotics. Patients were monitored for 12 months to evaluate infection recurrence and the need for surgical intervention. Results: The group treated with aPDT alone exhibited no recurrences throughout the 12-month follow-up period, making it the most effective approach. In contrast, patients receiving aPDT combined with anti-inflammatory drugs or antibiotics experienced higher recurrence rates, particularly within the first two months. Importantly, all patients initially recommended for tonsillectomy avoided surgery, with the highest impact observed in the aPDT + antibiotics group (45.5% avoided surgery). Conclusion: aPDT demonstrates significant efficacy in reducing recurrent tonsillitis episodes and preventing surgical intervention. The findings suggest that aPDT, particularly when used as a standalone treatment, can serve as a viable and non-invasive alternative to conventional therapeutic approaches, addressing both infection recurrence and antimicrobial resistance concerns.

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