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Due to a combination of host and microbial factors, NTHi persists in the lower airways of these individuals which is associated with an increased frequency of exacerbations, worsening symptoms, inflammation causing tissue damage, compositional changes to the lung microbiome and overall worse clinical prognosis (Sethi and Murphy, 2001

Typical improvements start to show between 2-4 weeks after the final session

One visit every two weeks for months 2-6

At present, routine use of dual therapy specifically to improve HF outcomes cannot be recommended because dedicated randomized HF trials are lacking

At the present level of our knowledge, it is safe to conclude that the orobuccal route can be used for treatment of hyperpigmentation with glutathione GSH at a dose of 10040050 mg per day for periods of between 10 and 12 weeks, depending upon indication, and it is hoped the treatment can be repeated to maintain effect