High and low doses of clarithromycin treatment are associated with different clinical efficacies and immunomodulatory properties in chronic rhinosinusitis
- PMID:24555753
- DOI: 10.1017/S0022215114000279
High and low doses of clarithromycin treatment are associated with different clinical efficacies and immunomodulatory properties in chronic rhinosinusitis
Abstract
Background: Low-dose clarithromycin has been recommended for the treatment of chronic rhinosinusitis without nasal polyps. However, it is uncertain whether a high dose of clarithromycin is more effective than a low dose.
Methods: Forty-three chronic rhinosinusitis patients were randomised to low-dose or high-dose clarithromycin groups, and clinical efficacy was evaluated. Pre- and post-treatment measures included: nasal symptom assessment, endoscopic inspection (Lund-Kennedy system), a quality of life questionnaire (the Sino-Nasal Outcome Test 20) and examination of cytokine levels (interleukin-5 and -8) in nasal secretions.
Results: The high dose of clarithromycin was significantly better in terms of clinical efficacy than the low dose for the treatment of chronic rhinosinusitis (p < 0.025). Significant differences in nasal cytokine levels (interleukin-5 and -8) were also observed between the low-dose and high-dose groups after short-term clarithromycin treatment (p < 0.025).
Conclusion: Short-term, high-dose clarithromycin appears to be more effective for the treatment of chronic rhinosinusitis than low-dose clarithromycin.
Similar articles
- Evaluation of long-term clarithromycin treatment in adult Chinese Patients with chronic rhinosinusitis without nasal polyps.Luo Q, Chen F, Liu W, Li Z, Xu R, Fan Y, Chen R, Xu Y, Liu Z, Xu G, Fu Q, Zuo K, Shi J, Li H; Nasal Health Group, China (NHGC).Luo Q, et al.ORL J Otorhinolaryngol Relat Spec. 2011;73(4):206-11. doi: 10.1159/000328342. Epub 2011 Jul 14.ORL J Otorhinolaryngol Relat Spec. 2011.PMID:21757966
- Lack of additional effects of long-term, low-dose clarithromycin combined treatment compared with topical steroids alone for chronic rhinosinusitis in China: a randomized, controlled trial.Deng J, Chen F, Lai Y, Luo Q, Xu R, Ou C, Fu Q, Shi J.Deng J, et al.Int Forum Allergy Rhinol. 2018 Jan;8(1):8-14. doi: 10.1002/alr.22041. Epub 2017 Nov 30.Int Forum Allergy Rhinol. 2018.PMID:29195025Clinical Trial.
- Effects of long-term clarithromycin treatment on lavage-fluid markers of inflammation in chronic rhinosinusitis.Cervin A, Wallwork B, Mackay-Sim A, Coman WB, Greiff L.Cervin A, et al.Clin Physiol Funct Imaging. 2009 Apr;29(2):136-42. doi: 10.1111/j.1475-097X.2008.00848.x. Epub 2008 Dec 8.Clin Physiol Funct Imaging. 2009.PMID:19076731
- Long-term low-dose macrolides for chronic rhinosinusitis in adults - a systematic review of the literature.Lasso A, Masoudian P, Quinn JG, Cowan J, Labajian V, Bonaparte JP, Kilty S.Lasso A, et al.Clin Otolaryngol. 2017 Jun;42(3):637-650. doi: 10.1111/coa.12787. Epub 2016 Nov 25.Clin Otolaryngol. 2017.PMID:27809411Review.
- Macrolide therapy of chronic rhinosinusitis.Cervin A, Wallwork B.Cervin A, et al.Rhinology. 2007 Dec;45(4):259-67.Rhinology. 2007.PMID:18085018Review.
Cited by
- Is there a role for antibiotics in the treatment of chronic rhinosinusitis?Smith SS, Kim R, Douglas R.Smith SS, et al.J Allergy Clin Immunol. 2022 May;149(5):1504-1512. doi: 10.1016/j.jaci.2022.02.004. Epub 2022 Feb 22.J Allergy Clin Immunol. 2022.PMID:35217148Free PMC article.Review.
- Survey about the use of clarithromycin in an ENT outpatient department of a tertiary hospital.Yan J, Shen J, Li Y, Tang F, Chen N.Yan J, et al.Eur Arch Otorhinolaryngol. 2017 Aug;274(8):3103-3107. doi: 10.1007/s00405-017-4607-7. Epub 2017 May 15.Eur Arch Otorhinolaryngol. 2017.PMID:28508178
- Systemic and topical antibiotics for chronic rhinosinusitis.Head K, Chong LY, Piromchai P, Hopkins C, Philpott C, Schilder AG, Burton MJ.Head K, et al.Cochrane Database Syst Rev. 2016 Apr 26;4(4):CD011994. doi: 10.1002/14651858.CD011994.pub2.Cochrane Database Syst Rev. 2016.PMID:27113482Free PMC article.Review.
- [Guideline for "rhinosinusitis"-long version : S2k guideline of the German College of General Practitioners and Family Physicians and the German Society for Oto-Rhino-Laryngology, Head and Neck Surgery].Stuck BA, Beule A, Jobst D, Klimek L, Laudien M, Lell M, Vogl TJ, Popert U.Stuck BA, et al.HNO. 2018 Jan;66(1):38-74. doi: 10.1007/s00106-017-0401-5.HNO. 2018.PMID:28861645German.No abstract available.
- The impact of total immunoglobulin E levels on outcomes of maximal medical therapy for chronic rhinosinusitis.Lemos-Rodriguez AM, Farzal Z, Sreenath SB, Thorp BD, Senior BA, Zanation AM, Ebert CS Jr.Lemos-Rodriguez AM, et al.Allergy Rhinol (Providence). 2017 Mar 1;8(1):5-12. doi: 10.2500/ar.2017.8.0188.Allergy Rhinol (Providence). 2017.PMID:28381321Free PMC article.
Publication types
MeSH terms
Substances
Related information
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical