Anti-inflammatory effects of macrolide antibiotics in the treatment of chronic rhinosinusitis

Cervin A. and Wallwork B. (2005) Anti-inflammatory effects of macrolide antibiotics in the treatment of chronic rhinosinusitis. Otolaryngologic Clinics of North America, 38 6: 1339-1350. doi:10.1016/j.otc.2005.08.002


Author Cervin A.
Wallwork B.
Title Anti-inflammatory effects of macrolide antibiotics in the treatment of chronic rhinosinusitis
Journal name Otolaryngologic Clinics of North America   Check publisher's open access policy
ISSN 0030-6665
Publication date 2005-01-01
Year available 2006
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.otc.2005.08.002
Volume 38
Issue 6
Start page 1339
End page 1350
Total pages 12
Publisher ANNALS FAMILY MEDICINE
Language eng
Subject 2733 Otorhinolaryngology
Abstract Apart from their obvious antibiotic effects, the macrolides have some potentially useful immunomodulatory properties. Which pathway dominates the clinical effect is debatable. Favoring the anti-inflammatory effects are the substantial in vitro data and serum concentrations well below minimal inhibitory concentrations for several pathogens. Furthermore, tissue reparative effects are seen in diffuse panbronchiolitis regardless of the presence of P aeruginosa, a pathogen not sensitive to macrolide antibiotics. Clinical studies support the view that prolonged treatment is likely to be beneficial in most patients who have CRS. The evidence concerning CRS is still weak because placebo-controlled trials are missing. One should remember, however, the general lack of placebo-controlled trials even in the "more established" medical management of CRS. The concern for an increasing incidence of macrolide-resistant bacterial strains must be taken seriously. Therefore the authors advocate repeated nasal cultures during macrolide therapy. It is hoped that the future will bring larger, prospective, randomized, controlled trials that will investigate the efficacy and safety of macrolides in CRS.
Keyword Medicine, General & Internal
General & Internal Medicine
MEDICINE, GENERAL & INTERNAL
PRIMARY HEALTH CARE
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: ResearcherID Downloads - Archived
 
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