title: Azithromycin for the treatment of eosinophilic nasal polyposis: Clinical and histologic analysis.
abstract: BACKGROUND
  Macrolides used as immunomodulators are a promising tool for chronic inflammatory airway diseases. Eosinophilic nasal polyposis (ENP) is still considered a disease that is difficult to control with the currently standardized treatments.
  
  
  OBJECTIVE
  To evaluate prolonged treatment with low-dose azithromycin for ENP based on clinical and histopathologic variables.
  
  
  METHODS
  The present investigation was a self-paired case study of 33 patients with ENP. A comparison was performed between patients before and after treatment with azithromycin for 8 weeks. The patients were subjected to clinical examinations, staging (three-dimensional imaging by endoscopy), application of the questionnaire, and biopsy of nasal polyps at the beginning and at the end of the treatment.
  
  
  RESULTS
  The treatment yielded a clinical improvement regarding the two variables studied: polyposis staging (69.7%) and questionnaire (57.6%). We did not find significant differences in the inflammatory pattern and in the percentage or absolute number of eosinophils per field between samples obtained before and after the treatment (p > 0.05). There was no difference between the answers obtained from groups with and without asthma and/or aspirin intolerance (p > 0.3). The patients with advanced initial staging exhibited lower subjective improvement index and staging reduction (p = 0.031 and p = 0.012, respectively).
  
  
  CONCLUSIONS
  Based on this study, azithromycin may be considered as another therapeutic option for ENP. However, further studies are necessary to define the real mechanism of action involved.
authors.affiliation: Post Graduate Program in Surgery and Ophthalmology, Universidade Federal de Minas Gerais [UFMG], Belo Horizonte, Brazil.
authors.forename: Isamara Simas
authors.initials: IS
authors.lastname: de Oliveira
authors.forename: Paulo Fernando Tormin
authors.initials: PF
authors.lastname: Borges Crosara
authors.forename: Geovanni Dantas
authors.initials: GD
authors.lastname: Cassali
authors.forename: Diego Carlos
authors.initials: DC
authors.lastname: Dos Reis
authors.forename: Danilo Santana
authors.initials: DS
authors.lastname: Rodrigues
authors.forename: Flavio Barbosa
authors.initials: FB
authors.lastname: Nunes
authors.forename: Roberto Eustáquio Santos
authors.initials: RE
authors.lastname: Guimarães