Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

A double-blind, randomized, placebo-controlled trial of macrolide in the treatment of chronic rhinosinusitis

Wallwork, B ; Coman, W ; Mackay-Sim, A ; Greiff, Lennart LU and Cervin, Anders LU (2006) In Laryngoscope 116(2). p.189-193
Abstract
Objectives: The antiinflammatory effect of macrolide antibiotics has been well-established, as has their role in the treatment of certain disorders of chronic airway inflammation. Several studies have suggested that long-term, low-dose macrolides may be efficacious in the treatment of chronic rhinosinusitis; however, these studies have lacked a control group. To date, this effect has not been tested in a randomized, placebo-controlled study. Method: The authors conducted a double-blind, randomized, placebo-controlled clinical trial on 64 patients with chronic rhinosinusitis. Subjects received either 150 mg roxithromycin daily for 3 months or placebo. Outcome measures included the Sinonasal Outcome Test-20 (SNOT-20), measurements of peak... (More)
Objectives: The antiinflammatory effect of macrolide antibiotics has been well-established, as has their role in the treatment of certain disorders of chronic airway inflammation. Several studies have suggested that long-term, low-dose macrolides may be efficacious in the treatment of chronic rhinosinusitis; however, these studies have lacked a control group. To date, this effect has not been tested in a randomized, placebo-controlled study. Method: The authors conducted a double-blind, randomized, placebo-controlled clinical trial on 64 patients with chronic rhinosinusitis. Subjects received either 150 mg roxithromycin daily for 3 months or placebo. Outcome measures included the Sinonasal Outcome Test-20 (SNOT-20), measurements of peak nasal inspiratory flow, saccharine transit time, olfactory function, nasal endoscopic scoring, and nasal lavage assays for interleukin-8, fucose, and a2-macroglobulin. Results. There were statistically significant improvements in SNOT-20 score, nasal endoscopy, saccharine transit time, and IL-8 levels in lavage fluid (P < .05) in the macrolide group. A correlation was noted between improved outcome measures and low IgE levels. No significant improvements were noted for olfactory function, peak nasal inspiratory flow, or lavage levels for fucose and a2-macroglobulin. No improvement in any outcome was noted in the placebo-treated patients. Conclusion: These findings suggest that macrolides may have a beneficial role in the treatment of chronic rhinosinusitis, particularly in patients with low levels of IgE, and supports the in vitro evidence of their antiinflammatory activity. Additional studies are required to assess their place in clinical practice. (Less)
Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
placebo-controlled, macrolide, chronic rhinosinusitis
in
Laryngoscope
volume
116
issue
2
pages
189 - 193
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000235566100005
  • pmid:16467702
  • scopus:33645784358
ISSN
1531-4995
DOI
10.1097/01.mlg.0000191560.53555.08
language
English
LU publication?
yes
id
91c0dafa-e95c-4a9d-9de9-5520de22d299 (old id 417078)
alternative location
http://www.laryngoscope.com/pt/re/laryngoscope/abstract.00005537-200602000-00005.htm;jsessionid=HP2TFXKmRkGblmGRQcHgfqLyTy2PY2JBXF4p05F2Y2bYj2Ft9qF4!-1323538283!181195628!8091!-1
date added to LUP
2016-04-01 15:50:48
date last changed
2021-10-03 04:36:42
@article{91c0dafa-e95c-4a9d-9de9-5520de22d299,
  abstract     = {Objectives: The antiinflammatory effect of macrolide antibiotics has been well-established, as has their role in the treatment of certain disorders of chronic airway inflammation. Several studies have suggested that long-term, low-dose macrolides may be efficacious in the treatment of chronic rhinosinusitis; however, these studies have lacked a control group. To date, this effect has not been tested in a randomized, placebo-controlled study. Method: The authors conducted a double-blind, randomized, placebo-controlled clinical trial on 64 patients with chronic rhinosinusitis. Subjects received either 150 mg roxithromycin daily for 3 months or placebo. Outcome measures included the Sinonasal Outcome Test-20 (SNOT-20), measurements of peak nasal inspiratory flow, saccharine transit time, olfactory function, nasal endoscopic scoring, and nasal lavage assays for interleukin-8, fucose, and a2-macroglobulin. Results. There were statistically significant improvements in SNOT-20 score, nasal endoscopy, saccharine transit time, and IL-8 levels in lavage fluid (P &lt; .05) in the macrolide group. A correlation was noted between improved outcome measures and low IgE levels. No significant improvements were noted for olfactory function, peak nasal inspiratory flow, or lavage levels for fucose and a2-macroglobulin. No improvement in any outcome was noted in the placebo-treated patients. Conclusion: These findings suggest that macrolides may have a beneficial role in the treatment of chronic rhinosinusitis, particularly in patients with low levels of IgE, and supports the in vitro evidence of their antiinflammatory activity. Additional studies are required to assess their place in clinical practice.},
  author       = {Wallwork, B and Coman, W and Mackay-Sim, A and Greiff, Lennart and Cervin, Anders},
  issn         = {1531-4995},
  language     = {eng},
  number       = {2},
  pages        = {189--193},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Laryngoscope},
  title        = {A double-blind, randomized, placebo-controlled trial of macrolide in the treatment of chronic rhinosinusitis},
  url          = {http://dx.doi.org/10.1097/01.mlg.0000191560.53555.08},
  doi          = {10.1097/01.mlg.0000191560.53555.08},
  volume       = {116},
  year         = {2006},
}