Recent Advances in Patient Treatment and Care (Track)

Clinical trial of long term clarithromycin treatment

Khashayar Ahmadi
Semnan university of medical sciences Imam hospital

Abstract:

Introduction: Chronic rhinosinusitis is defined as sinusitis lasting longer than 12 weeks. The purpose of this study was to examine the effect of long-term Clarithromycin treatment of patients with chronic sinusitis who did not respond to sinus surgery and traditional conservative therapy.

Methods: Thirty nine patients without immunodeficiency and with persistent symptoms of chronic sinusitis after one or several functional endoscopic sinus surgical procedures were included in the study. They had all been treated with systemic steroids and longterm antibiotics other than macrolides. Nasal swabs were performed for microbiological evaluation. All patients were treated with Clarithromycin 500 mg twice daily with other routine medications for chronic rhinosinusitis.

Results: Twenty six patients responded to the treatment (66.6%). There were no significant statistical differences between non-responders and responders in defined parameters at study commencement. After 3 months, in the Visual Analog Scale (VAS) scoring, the most significant change was in nasal obstruction (p<0.05). No significant changes were seen in the sense of smell. According to the results of microbiological investigation, Staphylococcus aureus was the most prevalent organism isolated from patients followed by Pseudomonas aureginosa and coagulase negative staphylococcus. At 3 months, there were no S. aureus on cultures.

Conclusion: Long-term, macrolide antibiotic therapy could be effective in some surgical failures of chronic sinusitis. The positive cultures did not seem to influence the improvement experienced by the patients. We recommend a minimum treatment period of 3 months to evaluate the efficacy of the treatment.