One-year low-dose erythromycin treatment of persistent chronic sinusitis after sinus surgery: clinical outcome and effects on mucociliary parameters and nasal nitric oxide.

Cervin, Anders; Kalm, Olof; Sandkull, Per; Lindberg, Sven

One-year low-dose erythromycin treatment of persistent chronic sinusitis after sinus surgery: clinical outcome and effects on mucociliary parameters and nasal nitric oxide.

Mark

Cervin, Anders ^LU ; Kalm, Olof ^LU ; Sandkull, Per and Lindberg, Sven ^LU (2002) In Otolaryngology: Head and Neck Surgery 126(5). p.481-489

Abstract: OBJECTIVE: In 17 patients with chronic sinusitis persistent after sinus surgery, long-term, low-dose erythromycin therapy was tested. The aim of the investigation was to study the clinical outcome and effects on nasal nitric oxide (NO), ciliary beat frequency (CBF), and mucociliary transport (saccharine transit time). STUDY DESIGN AND SETTING: We conducted a prospective open study at a tertiary teaching hospital. Symptoms were assessed using visual analog scales. NO was measured using a chemiluminescence analyzer, and mucociliary transport was measured with the saccharine crystal technique. CBF was measured in nasal brush samples using a phase contrast microscope. All patients were treated with erythromycin succinate 250 mg 2x daily or... (More); OBJECTIVE: In 17 patients with chronic sinusitis persistent after sinus surgery, long-term, low-dose erythromycin therapy was tested. The aim of the investigation was to study the clinical outcome and effects on nasal nitric oxide (NO), ciliary beat frequency (CBF), and mucociliary transport (saccharine transit time). STUDY DESIGN AND SETTING: We conducted a prospective open study at a tertiary teaching hospital. Symptoms were assessed using visual analog scales. NO was measured using a chemiluminescence analyzer, and mucociliary transport was measured with the saccharine crystal technique. CBF was measured in nasal brush samples using a phase contrast microscope. All patients were treated with erythromycin succinate 250 mg 2x daily or clarithromycin 250 mg 1x daily and were assessed after 3 months. In cases where there was no response, treatment was abandoned. The remaining patients (responders) were reassessed after 12 months of treatment. RESULTS: Of 17 patients, 12 responded to treatment. The 12-month follow-up showed an improvement in saccharine transit time (P < 0.05) but no significant change in CBF. There was a trend toward an increase in NO (P = 0.12). Endoscopic nasal examination scoring improved significantly (P < 0.01). In the visual analog scale scoring, the most pronounced improvements were seen in nasal congestion, sticky secretion, and runny nose at 3 and 12 months (P < 0.01). Improvements were also seen in headache (P < 0.05). CONCLUSION: The present study suggests that long-term, low-dose treatment with erythromycin is effective in persistent chronic sinusitis that does not respond to sinus surgery or systemic steroid/antibiotic treatment. SIGNIFICANCE: Long-term, low-dose erythromycin therapy seems to be a promising alternative when more conventional therapy fails. However, placebo-controlled studies are needed to validate the potential of this treatment. (Less)

Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/108911

author

Cervin, Anders ^LU ; Kalm, Olof ^LU ; Sandkull, Per and Lindberg, Sven ^LU

organization

Otorhinolaryngology (Lund)

publishing date

2002

type

Contribution to journal

publication status

published

subject

Otorhinolaryngology

keywords

Cilia : drug effects, Cilia : physiology, Adolescence, Adult, Aged, Antibiotics, Dose-Response Relationship, Drug, Erythromycin : administration & dosage, Erythromycin : therapeutic use, Female, Human, Male, Mucociliary Clearance : drug effects, Middle Age, Mucociliary Clearance : physiology, Nitric Oxide : analysis, Outcome Assessment (Health Care), Prospective Studies, Recurrence, Sinusitis : drug therapy, Time Factors, Non-U.S. Gov't, Support, Sinusitis : physiopathology, Sinusitis : surgery, Macrolide : administration & dosage, Macrolide : therapeutic use, Chronic Disease

in

Otolaryngology: Head and Neck Surgery

volume

126

issue

5

pages

481 - 489

publisher

Mosby-Elsevier

external identifiers

wos:000176308800005
pmid:12075221
scopus:0036559951

ISSN

0194-5998

DOI

10.1067/mhn.2002.124849

language

English

LU publication?

yes

id

06f87516-eca0-413d-b26a-d10db383c025 (old id 108911)

alternative location

http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12075221&dopt=Abstract

date added to LUP

2016-04-01 15:18:11

date last changed

2022-01-28 04:43:07

@article{06f87516-eca0-413d-b26a-d10db383c025,
  abstract     = {{OBJECTIVE: In 17 patients with chronic sinusitis persistent after sinus surgery, long-term, low-dose erythromycin therapy was tested. The aim of the investigation was to study the clinical outcome and effects on nasal nitric oxide (NO), ciliary beat frequency (CBF), and mucociliary transport (saccharine transit time). STUDY DESIGN AND SETTING: We conducted a prospective open study at a tertiary teaching hospital. Symptoms were assessed using visual analog scales. NO was measured using a chemiluminescence analyzer, and mucociliary transport was measured with the saccharine crystal technique. CBF was measured in nasal brush samples using a phase contrast microscope. All patients were treated with erythromycin succinate 250 mg 2x daily or clarithromycin 250 mg 1x daily and were assessed after 3 months. In cases where there was no response, treatment was abandoned. The remaining patients (responders) were reassessed after 12 months of treatment. RESULTS: Of 17 patients, 12 responded to treatment. The 12-month follow-up showed an improvement in saccharine transit time (P &lt; 0.05) but no significant change in CBF. There was a trend toward an increase in NO (P = 0.12). Endoscopic nasal examination scoring improved significantly (P &lt; 0.01). In the visual analog scale scoring, the most pronounced improvements were seen in nasal congestion, sticky secretion, and runny nose at 3 and 12 months (P &lt; 0.01). Improvements were also seen in headache (P &lt; 0.05). CONCLUSION: The present study suggests that long-term, low-dose treatment with erythromycin is effective in persistent chronic sinusitis that does not respond to sinus surgery or systemic steroid/antibiotic treatment. SIGNIFICANCE: Long-term, low-dose erythromycin therapy seems to be a promising alternative when more conventional therapy fails. However, placebo-controlled studies are needed to validate the potential of this treatment.}},
  author       = {{Cervin, Anders and Kalm, Olof and Sandkull, Per and Lindberg, Sven}},
  issn         = {{0194-5998}},
  keywords     = {{Cilia : drug effects; Cilia : physiology; Adolescence; Adult; Aged; Antibiotics; Dose-Response Relationship; Drug; Erythromycin : administration & dosage; Erythromycin : therapeutic use; Female; Human; Male; Mucociliary Clearance : drug effects; Middle Age; Mucociliary Clearance : physiology; Nitric Oxide : analysis; Outcome Assessment (Health Care); Prospective Studies; Recurrence; Sinusitis : drug therapy; Time Factors; Non-U.S. Gov't; Support; Sinusitis : physiopathology; Sinusitis : surgery; Macrolide : administration & dosage; Macrolide : therapeutic use; Chronic Disease}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{481--489}},
  publisher    = {{Mosby-Elsevier}},
  series       = {{Otolaryngology: Head and Neck Surgery}},
  title        = {{One-year low-dose erythromycin treatment of persistent chronic sinusitis after sinus surgery: clinical outcome and effects on mucociliary parameters and nasal nitric oxide.}},
  url          = {{http://dx.doi.org/10.1067/mhn.2002.124849}},
  doi          = {{10.1067/mhn.2002.124849}},
  volume       = {{126}},
  year         = {{2002}},
}

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One-year low-dose erythromycin treatment of persistent chronic sinusitis after sinus surgery: clinical outcome and effects on mucociliary parameters and nasal nitric oxide.