No Benefit of Long-Term Azithromycin for Rhinosinusitis

Low weekly dose of 500 mg for 11 weeks provides no benefit over placebo in chronic rhinosinusitis

WEDNESDAY, Sept. 14 (HealthDay News) -- For patients with persistent chronic rhinosinusitis (CRS), low-dose, long-term treatment with azithromycin (AZM) for 11 weeks offers no significant benefit, according to a study published online Sept. 2 in Allergy.

W. J. Videler, M.D., Ph.D., from the Academic Medical Centre in Amsterdam, Netherlands, and colleagues evaluated the efficacy of AZM treatment in 60 patients (median age, 49 years) with recalcitrant CRS with and without nasal polyps, who were unresponsive to optimal medical and surgical (92 percent cases) treatments. Patients were treated with either AZM or placebo. During the first week, AZM was given for three days at 500 mg per day, followed by 500 mg per week for the subsequent 11 weeks. Patients were followed-up for three months post-therapy using the Sino-Nasal Outcome Test-22 (SNOT-22), Patient Response Rating Scale, Visual Analogue Scale (VAS), Short Form-36 (SF-36), rigid nasal endoscopy, peak nasal inspiratory flow (PNIF), Sniffin Sticks smell tests, and endoscopically guided middle meatus cultures.

The investigators found that 50 percent of the patients had asthma and 58 percent underwent revision sinus surgery. The AZM and placebo groups did not differ significantly in SNOT-22, Patient Response Rating Scale, VAS scores, or SF-36. No relevant differences were observed between the two groups in nasal endoscopic findings, PNIF results, smell tests, or microbiology.

"At the investigated dose of AZM over three months, no significant benefit was found over placebo. Possible reasons could be disease severity in the investigated group, under-dosage of AZM, and under-powering of the study," the authors write.

The azithromycin and placebo used in this study were provided by PLIVA HRVATSKA.

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