Preliminary Findings: The Feasibility Study for a Randomized Controlled Trial of Clarithromycin in Chronic Rhinosinusitis.

Objectives: There is currently conflicting level 1 evidence in the use of long‐term antibiotics for chronic rhinosinusitis. The primary aim of this study was to look at recruitment and retention of patients in preparation for a formal trial. The aim of this paper is to describe the preliminary outcomes in terms of symptomatic relief in patients with CRSsNP. Methods: Adult patients fulfilling the EPOS criteria for CRSsNPs with no prior surgery were recruited in 6 UK centers during 2013. Participants received a 12‐week course of clarithromycin 250 mg alongside topical mometasone and nasal douching, all twice daily. Follow‐up was at 3 months and 6 months. For the purpose of this analysis, the Sinonasal Outcome Test (SNOT‐22) score was recorded at baseline and both follow‐up assessments. Results: Preliminary data from 29 patients at 3 months and 24 patients at 6 months showed significant symptomatic improvement in mean SNOT‐22 scores on paired t tests at 3 months (40.4 to 33.7, P =. 026), which was sustained at 6 months (30, P =. 02). The number of subjects showing ≥9 point reduction in SNOT‐22 scores was 45% (n = 13), increasing to 58% at 6 months (n = 14). Nine patients have been listed for surgery to date. Conclusions: While the results here do not have the power of the full randomized controlled trial, the findings suggest that long‐term macrolides have the potential to achieve significant symptomatic reduction in approximately 50% of patients with CRSsNPs. [ABSTRACT FROM AUTHOR]