The Role of Clarithromycin in Recurrent CRSwNP

Objective1) Evaluate the role of clarithromycin in recurrent CRSwNP. 2) Evaluate the factors related to clinical improvement after clarithromycin in recurrent CRSwNP.MethodThis was an open label study conducted in a tertiary setting in 2011 on patients with CRSwNP recurrent after surgery. Patients received clarithromycin for 12 weeks. Outcome measures included the SNOT‐20, NOSE, and Lund‐Kennedy scores. Blood testing at enrollment in the study included serum C3, C4, IgG, IgA, IgE, IgM, and eosinophil count.ResultsA total of 45 patients were enrolled. The patients showed a statistically significant improvement in SNOT‐20, NOSE, and Lund‐Kennedy scores after clarithromycin trial (P. 001), but only 46.7% of patients showed a clinically meaningful difference in SNOT‐20 higher than 0.8. There was statistically significant difference in serum IgG count between groups (P. 001). The analysis of this group of patients revealed a statistically insignificant difference in serum C3, C4, IgA, IgE, and IgM.ConclusionOur group of patients presents an improvement of QoL after clarithromycin treatment, and it was clinically meaningful in 46.7% of patients. This group showed a higher serum IgG, and perhaps this immunological imbalance is partially responsible for poor response in this group of patients.