The Role of Macrolides and Doxycycline in Chronic Rhinosinusitis

Katherine A. Lees; Richard R. Orlandi; Gretchen Oakley; Jeremiah A. Alt

doi:10.1016/j.iac.2019.12.005

The Role of Macrolides and Doxycycline in Chronic Rhinosinusitis

Katherine A. Lees, Richard R. Orlandi, Gretchen Oakley, Jeremiah A. Alt

Research output: Contribution to journal › Review article › peer-review

2 Scopus citations

Abstract

Antibiotic therapy has become an important adjunct in the management of recalcitrant chronic rhinosinusitis (CRS) because of some antibiotics’ immunomodulatory properties even at subtherapeutic antimicrobial levels. Macrolide antibiotics, such as clarithromycin and azithromycin, decrease production of proinflammatory cytokines, impair neutrophil recruitment, inhibit bacterial biofilm formation, and improve mucus quality. Doxycycline, a tetracycline antibiotic, inhibits the activity of matrix metalloproteinases in CRS with nasal polyposis. This article reviews the clinical applications for macrolide and doxycycline use in CRS, considerations for dosing and duration of treatment, and important side effects and drug interactions associated with these medications.

Original language	English (US)
Pages (from-to)	303-315
Number of pages	13
Journal	Immunology and Allergy Clinics of North America
Volume	40
Issue number	2
DOIs	https://doi.org/10.1016/j.iac.2019.12.005
State	Published - May 2020
Externally published	Yes

Keywords

Chronic
Doxycycline
Immunomodulation
Macrolides
Polyps
Rhinosinusitis
Sinusitis

ASJC Scopus subject areas

Immunology and Allergy
Immunology

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10.1016/j.iac.2019.12.005

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title = "The Role of Macrolides and Doxycycline in Chronic Rhinosinusitis",

abstract = "Antibiotic therapy has become an important adjunct in the management of recalcitrant chronic rhinosinusitis (CRS) because of some antibiotics{\textquoteright} immunomodulatory properties even at subtherapeutic antimicrobial levels. Macrolide antibiotics, such as clarithromycin and azithromycin, decrease production of proinflammatory cytokines, impair neutrophil recruitment, inhibit bacterial biofilm formation, and improve mucus quality. Doxycycline, a tetracycline antibiotic, inhibits the activity of matrix metalloproteinases in CRS with nasal polyposis. This article reviews the clinical applications for macrolide and doxycycline use in CRS, considerations for dosing and duration of treatment, and important side effects and drug interactions associated with these medications.",

keywords = "Chronic, Doxycycline, Immunomodulation, Macrolides, Polyps, Rhinosinusitis, Sinusitis",

author = "Lees, {Katherine A.} and Orlandi, {Richard R.} and Gretchen Oakley and Alt, {Jeremiah A.}",

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pages = "303--315",

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T1 - The Role of Macrolides and Doxycycline in Chronic Rhinosinusitis

AU - Lees, Katherine A.

AU - Orlandi, Richard R.

AU - Oakley, Gretchen

AU - Alt, Jeremiah A.

PY - 2020/5

Y1 - 2020/5

N2 - Antibiotic therapy has become an important adjunct in the management of recalcitrant chronic rhinosinusitis (CRS) because of some antibiotics’ immunomodulatory properties even at subtherapeutic antimicrobial levels. Macrolide antibiotics, such as clarithromycin and azithromycin, decrease production of proinflammatory cytokines, impair neutrophil recruitment, inhibit bacterial biofilm formation, and improve mucus quality. Doxycycline, a tetracycline antibiotic, inhibits the activity of matrix metalloproteinases in CRS with nasal polyposis. This article reviews the clinical applications for macrolide and doxycycline use in CRS, considerations for dosing and duration of treatment, and important side effects and drug interactions associated with these medications.

AB - Antibiotic therapy has become an important adjunct in the management of recalcitrant chronic rhinosinusitis (CRS) because of some antibiotics’ immunomodulatory properties even at subtherapeutic antimicrobial levels. Macrolide antibiotics, such as clarithromycin and azithromycin, decrease production of proinflammatory cytokines, impair neutrophil recruitment, inhibit bacterial biofilm formation, and improve mucus quality. Doxycycline, a tetracycline antibiotic, inhibits the activity of matrix metalloproteinases in CRS with nasal polyposis. This article reviews the clinical applications for macrolide and doxycycline use in CRS, considerations for dosing and duration of treatment, and important side effects and drug interactions associated with these medications.

KW - Chronic

KW - Doxycycline

KW - Immunomodulation

KW - Macrolides

KW - Polyps

KW - Rhinosinusitis

KW - Sinusitis

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The Role of Macrolides and Doxycycline in Chronic Rhinosinusitis

Abstract

Keywords

ASJC Scopus subject areas

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