Chronic rhinosinusitis (CRS), a persistent inflammatory condition of the sinuses, shows wide variation in management approaches, with endoscopic sinus surgery (ESS) rates differing fivefold and inconsistent antibiotic use due to limited evidence. To address this gap, a study compared the clinical effectiveness of ESS versus a 3-month course of clarithromycin alongside intranasal therapy in adults with CRS, with or without nasal polyps, involving 514 adults.
The study found that adults with chronic rhinosinusitis who underwent endoscopic sinus surgery had significantly greater improvement in Sino-Nasal Outcome Test (SNOT-22) scores at 6 months (adjusted mean difference –18·13) compared with those receiving clarithromycin or placebo (adjusted mean difference –20·44). No significant difference was observed between clarithromycin and placebo groups (adjusted mean difference –3·11),…
