Efficacy and safety of long-term antibiotics (macrolides) for the treatment of chronic rhinosinusitis

Cervin, Anders and Wallwork, Ben (2014) Efficacy and safety of long-term antibiotics (macrolides) for the treatment of chronic rhinosinusitis. Current Allergy and Asthma Reports, 14 3: 416.1-416.7. doi:10.1007/s11882-013-0416-2

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Author Cervin, Anders
Wallwork, Ben
Title Efficacy and safety of long-term antibiotics (macrolides) for the treatment of chronic rhinosinusitis
Journal name Current Allergy and Asthma Reports   Check publisher's open access policy
ISSN 1529-7322
1534-6315
Publication date 2014
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1007/s11882-013-0416-2
Open Access Status Not Open Access
Volume 14
Issue 3
Start page 416.1
End page 416.7
Total pages 7
Place of publication Philadelphia, PA United States
Publisher Springer Healthcare
Collection year 2015
Language eng
Subject 2723 Immunology and Allergy
2740 Pulmonary and Respiratory Medicine
Abstract Long-term treatment of airway inflammation/infection with macrolide antibiotics has now been in use for almost 30 years. Whereas the beneficial clinical effect in cystic fibrosis and COPD have been backed up by randomized controlled trials, the evidence from the upper airways is not as strong. We have identified 22 open studies in chronic rhinosinusitis, with and without polyps, but only 2 randomized controlled trials. Of the controlled trials, the one including CRS patients just without polyps, showed a significant effect in sino-nasal outcome test, saccharine transit time, nasal endoscopy, and IL-8 levels in lavage fluid after 12 weeks of roxithromycin, whereas, in the other RCT with a mixed study group of CRS patients with and without polyps, 12 weeks of azithromycin showed no effect compared to placebo. Concerns regarding the risk of macrolides to induce arrhythmia have been raised. Recent FDA guidelines changes has recommended caution in patients with risk factors such as long QT syndrome, bradycardia, hypokalemia, or hypomagnesemia. Ototoxicity is another concern. Long-term macrolide antibiotics in the treatment of CRS patients is still a viable option in a select group of patients.
Keyword Adverse effects
Airway
Antibiotics
Azithromycin
Chronic rhinosinusitis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2015 Collection
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 14 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 5 times in Scopus Article | Citations
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