xRead - Nasal Obstruction (September 2024) Full Articles

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International consensus statement on rhinosinusitis

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TABLE X-24 Evidence for CRSwNP management with macrolide antibiotics Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions Seresirikachorn 1121 2019 1 Meta-analysis CRSsNP or CRSwNP. 10 studies SNOT Symptom score CTscore Endoscopy score Favorable outcomes in patients with CRSsNP, but not in patients with CRSwNP. Huang 1118 2019 1 Meta-analysis CRSsNP or CRSwNP. 7 studies TNSS VAS Endoscopic score CTscore Adding clarithromycin to intranasal steroid spray may yield better results than intranasal steroid spray alone. Lasso 1634 2017 1 Meta-analysis CRSsNP and CRSwNP. 9 RCT Positive results were found with macrolide therapy in the postoperative period in patients with nasal polyps. Cervin 1120 2014 1 Meta-analysis CRSsNP and CRSwNP. 2 RCTs, 22 Open/cohort studies Long-term macrolide is an option for selected CRS patients Pynnonen 1117 2013 1 Meta-analysis CRSsNP and CRSwNP. 3 RCT SNOT-20 and SNOT-22 Insufficient evidence to support long-term macrolide therapy Varvyanskaya 1632 2014 2 RCT Clarithromycin postoperatively 250 mg daily for 24 weeks (n = 22) Clarithromycin postoperatively 250 mg daily for 12 weeks (n = 22) Control (n = 22) SNOT-20 VAS Olfaction Endoscopy SCT Acoustic rhinometry CTscore Significant improvement of all parameters except acoustic rhinometry and VAS in both clarithromycin groups as compared with controls. Peric 1631 2014 2 RCT Clarithromycin preoperatively 500 mg daily for 8 weeks, followed by ESS (n = 40) ESS (n = 40) Nasal symptom score Endoscopic score Preoperative clarithromycin administration postponed nasal polyp relapse after ESS.