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Current Allergy and Asthma Reports
Published in: Current Allergy and Asthma Reports 5/2017

01-05-2017 | Rhinosinusitis (J Mullol, Section Editor)

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

Authors: Gretchen M. Oakley, Richard J. Harvey, Valerie J. Lund

Published in: Current Allergy and Asthma Reports | Issue 5/2017

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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.

Summary

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.
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Metadata
Title
The Role of Macrolides in Chronic Rhinosinusitis (CRSsNP and CRSwNP)
Authors
Gretchen M. Oakley
Richard J. Harvey
Valerie J. Lund
Publication date
01-05-2017
Publisher
Springer US
Published in
Current Allergy and Asthma Reports / Issue 5/2017
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-017-0696-z

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