The aim of this study is to evaluate the efficacy and safety of prolonged
therapy with low-dose
clarithromycin in patients with chronic
rhinosinusitis with
polyps (CRSwP) after endoscopic sinus surgery (ESS). A total of 10 patients with CRSwP were identified and subjected to bilateral ESS. In post-operative patients they were treated with nasal wash with
saline solution and
steroid sprays (
beclomethasone). During follow-up, after 30-40 days after the operation (M = 35.4 SD = +4.33), patients reported a worsening of symptoms with onset of
nasal obstruction; reduction/
loss of smell;
headache; onset of viscous secretions and therefore all patients continued
therapy with saline nasal irrigation, topical
steroid therapy and started
macrolide (
clarithromycin 500 mg/pill: 1 pill/day for 3 days a week for 1 month). 22-item SinoNasal Outcome Test (SNOT-22) and a score to the endoscopic evaluation (endoscopic appearance score, EAS) before and
after treatment were performed to evaluate efficacy of treatment. The results of the SNOT-22 and EAS showed statistically significant improvements (p < 0.05) for some parameters such as: the need to blow nose,
sneezing,
hyposmia, viscous mucous secretions about the SNOT-22 and reduction of secretions and
edema of the nasal mucosa about the EAS. The preliminary results of our study show that the low-dose
clarithromycin for a period of 1 month can improve patient complaints with CRSwP not only through the antibacterial properties but also for the immunomodulatory characteristics.