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 and Lindberg, Sven (2002) One-year low-dose erythromycin treatment of persistent chronic sinusitis after sinus surgery: clinical outcome and effects on mucociliary parameters and nasal nitric oxide. Otolaryngology - Head and Neck Surgery, 126 5: 481-489. doi:10.1067/mhn.2002.124849


Author Cervin, Anders
Kalm, Olof
Sandkull, Per
Lindberg, Sven
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
Journal name Otolaryngology - Head and Neck Surgery   Check publisher's open access policy
ISSN 0194-5998
1097-6817
Publication date 2002-05
Sub-type Article (original research)
DOI 10.1067/mhn.2002.124849
Open Access Status Not yet assessed
Volume 126
Issue 5
Start page 481
End page 489
Total pages 9
Place of publication Thousand Oaks, CA, United States
Publisher Sage Publications
Language eng
Formatted 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 and Setting: We conducted a prospective open study at a tertiary teaching hospital. Symptoms were 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 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 (  < 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. 
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 47 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 64 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Thu, 20 Mar 2014, 08:13:46 EST by System User on behalf of Learning and Research Services (UQ Library)