Treatment of chronic rhinosinusitis with low dose, long term macrolide antibiotics An evolving paradigm英文电子书.pdf

Treatment of Chronic Rhinosinusitis with Low-dose, Long-term Macrolide Antibiotics: An Evolving Paradigm Umur Hatipoglu, MD, and Israel Rubinstein, MD Address Epidemiologic studies are probably limited by the Department of Medicine (M/C 719), University of Illinois at Chicago, lack of consensus on clinical criteria for diagnosis of 840 South Wood Street, Room 913, Chicago, IL 60616-7323, USA. chronic adult rhinosinusitis. However, significant eco- E-mail: IRubinst@uic.edu nomic burden is inferred from these studies. It is estimated Current Allergy and Asthma Reports 2005, 5:491–494 that chronic rhinosinusitis was the reason for 24 million Current Science Inc. ISSN 1529-7322 office visits in the United States in 1992 as well as 73 Copyright © 2005 by Current Science Inc. million days of restricted activity between 1990 and 1992 [2]. When indirect costs were taken into account, an esti- The 14-membered and 15-membered ring macrolide mated $5.8 billion were spent for the care of patients with antibiotics express immunomodulatory effects in chronic chronic rhinosinusitis in 1996 [3]. respiratory disorders in humans that are distinct from their antimicrobial properties. These drugs downregulate the excessive immune and inflammatory responses observed in Pathophysiology these conditions while promoting tissue repair. To this end,