title: Optimal duration of macrolide treatment for chronic sinusitis after endoscopic sinus surgery.
abstract: OBJECTIVE
  The objective is to determine the appropriate duration of postoperative macrolide therapy for chronic rhinosinusitis to obtain a favourable outcome with endoscopic sinus surgery (ESS).
  
  
  METHODS
  The effectiveness of postoperative macrolide treatment was examined in patients with chronic rhinosinusitis who underwent ESS, by comparing 3-month (44 patients) and 6-month administration (66 patients) of clarithromycin (CAM) (200mg/day). Evaluation was made based on subjective symptoms and endoscopic findings at 3, 6 and 12 months after surgery.
  
  
  RESULTS
  Seventeen (3-month CAM group) and 22 (6-month CAM group) subjects were able to be followed up to 12 months after surgery. No difference in effectiveness was observed between the groups until 6 months after surgery, but the 6-month treatment group showed significantly higher disappearance rates and significantly lower visual analogue scale (VAS) scores in the subjective symptoms of rhinorrhea and postnasal drip at 12 months after surgery. The positive finding rate of postnasal drip by endoscopic examination was also significantly lower in the 6-month treatment group at 12 months after surgery. These changes over time indicated gradual deterioration after discontinuation of CAM treatment in the 3-month treatment group, whereas a small improvement was observed after discontinuation in the 6-month treatment group.
  
  
  CONCLUSIONS
  The results indicate that chronic sinusitis patients with rhinorrhea or postnasal drip should be treated with macrolides for 6 months after surgery in order to improve the long-term outcome of endoscopic sinus surgery.
authors.affiliation: Department of Otorhinolaryngology, Nagoya-city University School of Medicine, Japan. y-naka@med.nagoya-cu.ac.jp
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Motohiko
authors.initials: M
authors.lastname: Suzuki
authors.forename: Makoto
authors.initials: M
authors.lastname: Yokota
authors.forename: Shinya
authors.initials: S
authors.lastname: Ozaki
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Ohno
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hamajima
authors.forename: Meiho
authors.initials: M
authors.lastname: Nakayama
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Hashiba
authors.forename: Shingo
authors.initials: S
authors.lastname: Murakami
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002908:Chronic Disease / Q000628:therapy; D017291:Clarithromycin / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004724:Endoscopy; D006801:Humans; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D010256:Paranasal Sinuses / Q000601:surgery*; D012220:Rhinitis / Q000188:drug therapy* / Q000601:surgery; D012852:Sinusitis / Q000188:drug therapy* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin