The Role of Macrolides in Chronic Rhinosinusitis (CRSsNP and CRSwNP).

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The Role of Macrolides in Chronic Rhinosinusitis (CRSsNP and CRSwNP).

Curr Allergy Asthma Rep. 2017 May;17(5):30

Authors: Oakley GM, Harvey RJ, Lund VJ

Abstract
PURPOSE OF REVIEW: We assess the literature on the pharmacokinetics, indications, important considerations, and effectiveness of long-term, low-dose macrolide antibiotics in chronic rhinosinusitis (CRS).
RECENT FINDINGS: The key to effective implementation of macrolide therapy in CRS is appropriate patient selection. Macrolides have demonstrated the most benefit in Th1-mediated non-eosinophilic CRS when used for durations of at least 3 months. Macrolide antibiotics have demonstrated great benefit when used for their anti-inflammatory or immunomodulatory properties, which include the blockage of pro-inflammatory cytokines, such as interleukin (IL)-8 and tumor necrosis factor-α (TNF-α). They have been used in CRS patients not responding to traditional corticosteroid-based treatment regimens, but appear to be most effective specifically in Th1-mediated non-eosinophilic CRS in long durations and low doses. Further research is needed to better identify characteristics known to correlate with macrolide response so early directed therapy can be implemented.

PMID: 28429305 [PubMed - in process]

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