High and low doses of clarithromycin treatment are associated with different clinical efficacies and immunomodulatory properties in chronic rhinosinusitis. Issue 3 (March 2014)

• Record Type: Journal Article
• Authors: Fan, Y; Xu, R; Hong, H; Luo, Q; Xia, W; Ding, M; Shi, J; Lv, M; Li, H
• Is Part Of: Journal of laryngology & otology. Volume 128:Issue 3(2014)
• Page Start: 236
• Page End: 241
• Publication Date: 2014-03
• Subjects: Otolaryngology -- Periodicals; 617.51
• DOI: 10.1017/S0022215114000279
• Languages: English
• ISSNs: 0022-2151

Abstract

<abstract abstract-type="normal"> <title>Abstract</title> <sec id="sec1"> <title>Background:</title> <p>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.</p> </sec> <sec id="sec2"> <title>Methods:</title> <p>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.</p> </sec> <sec id="sec3"> <title>Results:</title> <p>The high dose of clarithromycin was significantly better in terms of clinical efficacy than the low dose for the treatment of chronic rhinosinusitis (<italic>p</italic> &lt; 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 (<italic>p</italic> &lt; 0.025).</p> </sec> <sec id="sec4"> <title>Conclusion:</title> <p>Short-term, high-dose clarithromycin appears to be more effective for the treatment of chronic rhinosinusitis than low-dose clarithromycin.</p> </sec> </abstract>