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.

• Authors: Y Fan, R Xu, H Hong, Q Luo, W Xia, M Ding, J Shi, M Lv, H Li
• Journal: The Journal of laryngology and otology (J Laryngol Otol) Vol. 128 Issue 3 Pg. 236-41 (Mar 2014) ISSN: 1748-5460 [Electronic] England
• PMID: 24555753 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Biomarkers
• Interleukin-5
• Interleukin-8
• Clarithromycin

Topics

• Adult
• Anti-Bacterial Agents (administration & dosage)
• Biomarkers (metabolism)
• Chronic Disease
• Clarithromycin (administration & dosage)
• Dose-Response Relationship, Drug
• Female
• Humans
• Interleukin-5 (metabolism)
• Interleukin-8 (metabolism)
• Male
• Middle Aged
• Quality of Life
• Rhinitis (complications, drug therapy, immunology)
• Sinusitis (complications, drug therapy, immunology)
• Surveys and Questionnaires
• Treatment Outcome