RESUMO
The aim of this work was to study efficacy and safety of long-term low-dose clarithromycin therapy of chronic polypous rhinosinusitis during 6 months after endoscopic polyposinusotomy. 112 patients aged 25-65 yr were randomized in groups 7 days after surgery. Those in group 1 (n=66) received topic corticosteroid treatment in combination with clarithromycin (250 mg/day for 3 mo). The use of clarithromycin significantly decreased the number of clinical symptoms and improved quality of life. CT examination showed significant reduction in the frequency of relapses, episodes of acute respiratory viral infections, and their bacterial complications. All these effects persisted for 3 mo after withdrawal of clarithromycin.
Assuntos
Claritromicina/administração & dosagem , Pólipos Nasais , Procedimentos Cirúrgicos Nasais , Complicações Pós-Operatórias/tratamento farmacológico , Rinite/terapia , Sinusite/terapia , Adulto , Antibacterianos/administração & dosagem , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/patologia , Mucosa Nasal/fisiopatologia , Mucosa Nasal/cirurgia , Pólipos Nasais/patologia , Pólipos Nasais/fisiopatologia , Pólipos Nasais/terapia , Procedimentos Cirúrgicos Nasais/efeitos adversos , Procedimentos Cirúrgicos Nasais/métodos , Seios Paranasais/patologia , Seios Paranasais/fisiopatologia , Seios Paranasais/cirurgia , Radiografia , Rinite/diagnóstico por imagem , Rinite/fisiopatologia , Prevenção Secundária , Sinusite/diagnóstico por imagem , Sinusite/fisiopatologia , Tempo , Resultado do TratamentoRESUMO
A total of 37 patients at the age from 25 to 65 years presenting with chronic polipoid rhinosinusitis (CPRS) were available for the observation. They were allocated to two groups based on the results of endoscopic polyposinusotomy. The patients in group 1 (n=18) were instructed at discharge from the clinic to take 250 mg of clarithromycin daily for 3 months in combination with the local application of a topical corticosteroid. The patients in group 2 (n=19) were prescribed topical corticosteroids alone. It was shown that clarithromycin at low doses caused significant stabilization of CPRS remission and prevented the development of relapses in the majority of the patients (66%). Therapy of CPRS with low doses of clarithromycin was associated with a significant decrease of the frequency of acute retroviral infections (ARVI). The intake of clarithromycin had no effect on the development and/or aggravation of intestinal dysbacteriosis nor did it provoke deviation of blood biochemical characteristics from the normal values both at the onset of therapy and after a follow-up period of 3 months.
