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Open Access Azithromycin for the treatment of eosinophilic nasal polyposis: Clinical and histologic analysis

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Introduction:

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.

Objectives:

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).

Conclusion:

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.

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Keywords: Nasal polyps; azithromycin; endoscopy; eosinophils; questionnaires; three-dimensional imaging

Document Type: Research Article

Publication date: 2016-01-01

More about this publication?
  • In the fields of rhinology & allergy, as in all medical fields, there is a need for a greater number of journals which publish in the open access format. The underlying spirit of this format is to break down the barriers to knowledge sharing. Allergy & Rhinology, was created to serve this need; and is proud to take the lead in publishing quality research work as an experiment in the open format. As long as the fiscal model works, the Journal shall allow all users the right to freely read, download, copy, distribute, print, search, or link to the full texts of its articles.

    The academic standard of Allergy & Rhinology is designed to be no different than traditional subscription-based, scientific and scholarly journals in that the quality of the research work which it publishes shall meet the rigors of peer-review and other scholarly quality controls.

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