| Effects of Low-Dose Long-Term Macrolide Therapy on the Postoperative Symptom Change, Mucociliary Clearance and Polyp Regrowth |
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Young Hwan Lim, Jae Myeong Kim, Jun Yeon Hwang, Tae Young Kwon, Yong Bok Kim, Sung Wan Kim |
1Department of Otolaryngology-Head and Neck Surgery, Kang-Nam General Hospital, Public Corporation, Seoul, Korea. drkimsw@mdhouse.com
2Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hallym Unversity, Hangang Sacred Heart Hospital, Seoul, Korea. |
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| Abstract |
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Low-dose long-term macrolide therapy (LDLMT) has been reported as an effective treatment in chronic respiratory tract diseases such as diffuse panbronchiolitis and chronic paranasal sinusitis. The mechanism of action of LDLMT is not fully revealed. The aim of this study was to evaluate the clinical effect of LDLMT on the postoperative patients of chronic sinusitis with polyp. Thirty eight control groups were defined empirically treated with antibiotics after endoscopic sinus surgery (ESS) and 62 experimental group were defined 8 weeks LDLMT (Clarithromycin 250 mg ) after postoperative 2 weeks in ESS patients. Preoperatively, we checked mucociliary clearance with saccharine test (MCT), symptom scores and sinus CT scan and total IgE, and allerg ic skin test were evaluated for allergy. After ESS, MCT and symptom scores were checked on postoperative patients at 2, 6 and 10 weeks, respectively. Recurrence of polyp was also evaluated with endoscopic examination. The improvement rate (IR) of MCT was s ignificantly higher in the experimental group than in the control group, but the IR of symptom scores was not significant statistically. High total IgE affected the IR of MCT and symptom scores in the experimental group. Allergy proven by allergic skin test also affected the IR of MCT, but the IR of symptom scores was not affected in the experimental group. The polyp recurrence rate was significantly higher in the control group compared to the experimental group. We can conclude that LDLMT has a beneficial affect on the postoperative treatment of sinusitis patients and high total IgE and allergy may affect the effect of LDLMT in postoperative patients who have undergone ESS. |
| Key Words:
Macrolide;Anti-inflammatory effect;Chronic sinusitis;Nasal polyps |
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