title: Effects of Preoperative Clarithromycin Administration in Patients with Nasal Polyposis.
abstract: OBJECTIVE
  In recent years, various investigators have shown considerable interest in the use of macrolide antibiotics for treatment of chronic rhinosinusitis and nasal polyposis. The aim of this study was to evaluate the clinical effects of preoperative long-term, low-dose clarithromycin administration in patients with nasal polyposis.
  
  
  METHODS
  Eighty nasal polyp patients (42 non-atopic and 38 atopic) were included in this prospective, non-placebo controlled investigation and randomized equally to either the combined clarithromycin-surgical or surgical group. Forty patients received 500 mg of clarithromycin daily for eight weeks, and, after evaluation, they were treated by functional endoscopic sinus surgery (FESS). The other 40 patients were treated only surgically. The nasal symptom scores and endoscopic scores after macrolide treatment/surgical treatment, and after six and 12 months of follow-up were evaluated.
  
  
  RESULTS
  After clarithromycin therapy, we found improvement in symptom scores in 25/40, and improvement in endoscopic scores in 19/40 patients. We found no significant difference in nasal symptom score between allergic and non-allergic patients regarding the outcome to macrolide (p = 0.352) or surgical treatment (p = 0.396). When we compared differences between endoscopic scores at the time points of 12 months and six months postoperatively (ESt12 minus ESt6), we found statistically lower differences in the clarithromycin-surgery group than in the surgery group (p = 0.006).
  
  
  CONCLUSIONS
  Preoperative clarithromycin administration postponed nasal polyp relapse after FESS. Allergies have no influence on the clinical efficacy of clarithromycin therapy and on the efficacy of FESS.
authors: Department of Otorhinolaryngology, Rhinology Unit, Faculty of Medicine, Military Medical Academy, Crnotravska 17, 11040 Belgrade, Serbia. alexneta@sezampro.rs.
authors: A
authors: A
authors: Perić
authors: Department of Otorhinolaryngology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
authors: N
authors: N
authors: Baletić
authors: Department of Otorhinolaryngology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
authors: M
authors: M
authors: Milojević
authors: Department of Otorhinolaryngology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
authors: J
authors: J
authors: Sotirović
authors: Department of Otorhinolaryngology, Faculty of Medical Sciences, Clinical Centre Kragujevac, Serbia.
authors: L
authors: L
authors: Živić
authors: Institute of Pharmacy, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
authors: A V
authors: AV
authors: Perić
authors: Institute of Medical Research, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
authors: D
authors: D
authors: Vojvodić