Table 1 Results of the Delphi survey
Statement | Consensus score | |
|---|---|---|
Disagreement (score 1–3) (%) | Agreement (score 4–6) (%) | |
Topic 1 - Mechanism of action | ||
1. The different modes of action of Benzydamine in the treatment of sore throat are: | ||
(1.1) Anti-inflammatory | 0% | 100% |
(1.2) Anesthetic | 21% | 79% |
(1.3) Analgesic | 1% | 99% |
(1.4) Antiseptic | 1% | 99% |
(2) The anti-inflammatory activity of Benzydamine has been related to its ability to inhibit the release of pro-inflammatory cytokines (TNFa, IL-1β, and MCP-1), without affecting other anti-inflammatory factors, thus not presenting the side effects characteristic of aspirin-like drugs. | 1% | 99% |
(3) Differently from other NSAIDs, Benzydamine exhibits local anesthetic properties by modulating neuronal sodium-dependent excitability so when applied topically in clinically relevant concentrations it exerts its effect on pain. | 1% | 99% |
Topic 2 – Adult patient | ||
(4) According to my experience, the decision to prescribe/recommend Benzydamine is based on the presence of the following symptoms: | ||
(4.1) Ache | 5% | 95% |
(4.2) Itchy throat | 25% | 75% |
(4.3) Dry throat | 29% | 71% |
(4.4) Difficulty in swallowing | 6% | 94% |
(4.5) Redness of the throat | 9% | 91% |
(4.6) Cough | 9% | 91% |
(5) In the absence of bacterial infections, antibiotics should not be used to provide symptomatic relief in sore throat. Either non-steroidal anti-inflammatory drugs or paracetamol are recommended for relief of acute sore throat symptoms. | 1% | 99% |
(6) I recommend Benzydamine for the short-term symptomatic treatment of acute sore throat. | 2% | 98% |
(7) According to my experience, Benzydamine is preferred over other local analgesics to reduce symptoms of acute sore throat. | 12% | 88% |
(8) Benzydamine is effective on preventing post-operative sore throat. | 33% | 67% |
Topic 3 – Pediatric patient | ||
(9) According to my experience, the decision to prescribe/recommend Benzydamine is based on the presence of the following symptoms: | ||
(9.1) Ache | 4% | 96% |
(9.2) Itchy throat | 19% | 81% |
(9.3) Dry throat | 23% | 77% |
(9.4) Difficulty in swallowing | 7% | 93% |
(9.5) Redness of the throat | 6% | 94% |
(9.6) Cough | 9% | 91% |
(10) Ibuprofen or paracetamol is recommended for the relief of general pain or fever associated with acute pharyngitis. | 1% | 99% |
(11) I recommend Benzydamine (mouthwash or losenges or spray) for the short-term symptomatic treatment of acute sore throat. | 4% | 96% |
(12) According to my experience, Benzydamine (mouthwash or losenges or spray) is preferred over other local analgesics to reduce symptoms of acute sore throat. | 15% | 85% |
Topic 4 – Advantages of Benzydamine over other topical treatments | ||
(13) Benzydamine may quickly reduce the pain of acute sore throat. | 0% | 100% |
(14) The mechanisms of action of Benzydamine, especially its local anesthetic activity, according to my experience, constitute a plus compared to other topically administered drugs. | 0% | 100% |
(15) The combined anti-inflammatory activity of Benzydamine with its local anesthetic and analgesic properties, and its antiseptic activity, according to my experience, constitute an advantage over other topically administered drugs. | 2% | 98% |