{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T12:01:44Z","timestamp":1770724904032,"version":"3.49.0"},"reference-count":26,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T00:00:00Z","timestamp":1591056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Oral supplements (OS) support the immune system in fighting upper airways infection. This study aimed to analyze the effect of Difensil Immuno (DI) on the recurrence of tonsillitis and fever in children. A multicentric randomized clinical trial was conducted. One-hundred and twenty children with chronic tonsillitis were randomly assigned to group A, B or control. Patients in group A were treated with 10 mL of DI for 90 consecutive days, patients in group B underwent treatment with 15 mL of DI for 45 consecutive days. The following data were collected at baseline (T0), T1 and T2: tonsillitis and fever episodes, tonsillar volume, blood test results. One-way ANOVA was used to analyze within and between variances. Patients in group A and B statistically improved their clinical parameters (episode of tonsillitis and fever, tonsillar volume) when compared to control group both at T1 and T2. However, T1 variances were more consistent in group A than in group B. All patients in the study groups improved their clinical outcomes. No statistically significant variances were observed in blood parameters both at T1 and T2. Our results suggest that children treated with DI had fewer episodes of tonsillitis and fever and a reduction in their tonsillar volume.<\/jats:p>","DOI":"10.3390\/nu12061637","type":"journal-article","created":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T04:09:03Z","timestamp":1591070943000},"page":"1637","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Difensil Immuno Reduces Recurrence and Severity of Tonsillitis in Children: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5510-3814","authenticated-orcid":false,"given":"Arianna","family":"Di Stadio","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, University of Perugia, 06129 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"della Volpe","sequence":"additional","affiliation":[{"name":"Otology and Cochlear Implant Unit, Santobono-Pausilipon Children\u2019s Hospital, 80129 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiammetta M.","family":"Korsch","sequence":"additional","affiliation":[{"name":"Otology and Cochlear Implant Unit, Santobono-Pausilipon Children\u2019s Hospital, 80129 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonietta","family":"De Lucia","sequence":"additional","affiliation":[{"name":"Otology and Cochlear Implant Unit, Santobono-Pausilipon Children\u2019s Hospital, 80129 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8776-0421","authenticated-orcid":false,"given":"Massimo","family":"Ralli","sequence":"additional","affiliation":[{"name":"Sense Organs Department, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Martines","sequence":"additional","affiliation":[{"name":"Biomedicine, Neuroscience and Advanced Diagnostics Department, University of Palermo, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giampietro","family":"Ricci","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Perugia, 06129 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1080\/14712598.2019.1638907","article-title":"Challenges in the management of HIV infection: Update on the role of probiotic supplementation as a possible complementary therapeutic strategy for cART treated people living with HIV\/AIDS","volume":"19","author":"Ceccarelli","year":"2019","journal-title":"Expert Opin. 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