The role of macrolides in chronic rhinosinusitis (CRSsNP and CRSwNP)

Gretchen M. Oakley*, Richard J. Harvey, Valerie J. Lund

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

19 Citations (Scopus)


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.

Original languageEnglish
Article number30
Pages (from-to)1-10
Number of pages10
JournalCurrent Allergy and Asthma Reports
Issue number5
Publication statusPublished - May 2017


  • macrolide
  • chronic rhinosinusitis
  • sinusitis
  • non-eosinophilic
  • medical management

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