{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:12:58Z","timestamp":1793070778162,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,2,11]],"date-time":"2019-02-11T00:00:00Z","timestamp":1549843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the prognostic factors that predict favorable outcomes of low\u2010dose macrolides (LDMs) in treating chronic rhinosinusitis (CRS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Randomized controlled trials studying the effects of LDMs in treating CRS were included. Data were pooled for meta\u2010analysis. Primary outcome was Sino\u2010Nasal Outcome Test (SNOT). Six prognostic factors: CRS subtypes, serum immunoglobulin (Ig)E level, membered lactone ring of macrolides, concurrent endoscopic sinus surgery (ESS), and dosage and duration of the LDMs were assessed by subgroup analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten studies (608 patients) met the inclusion criteria. LDMs and placebo were not different in SNOT improvement (standardized mean difference [SMD]\u2009=\u2009\u22120.23, 95% confidence interval [CI]: \u22120.69 to 0.24). Subgroup analyses showed that the effects favored LDMs in the patients with CRS without polyps (SMD\u2009=\u2009\u22120.64, 95% CI: \u22121.01 to \u22120.27) compared to CRS with polyps, and the patients receiving a half dose (SMD\u2009=\u2009\u22120.64, 95% CI: \u22121.01 to \u22120.27) compared to a very low dose. There was no difference in SNOT improvement between LDMs plus standard treatment compared to standard treatment (SMD\u2009=\u2009\u22120.52, 95% CI: \u22121.57 to 0.53). Subgroup analyses showed that the effects favored LDMs in the patients receiving LDMs for a duration of 24\u2009weeks (SMD\u2009=\u2009\u22121.68, 95% CI: \u22122.40 to \u22120.95) compared to 8 and 12\u2009weeks. There was no difference between the 14\u2010membered and 15\u2010membered ring LDMs. Assessment of concurrent ESS found mixed results. Serum IgE level could not be assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>LDMs provided favorable outcomes in patients with CRS without polyps. A half dose of macrolides should be given for a duration of 24\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>1a<\/jats:p><jats:p><jats:italic>Laryngoscope<\/jats:italic>, 129:1510\u20131519, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27865","type":"journal-article","created":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T08:41:07Z","timestamp":1549960867000},"page":"1510-1519","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Factors of success of low\u2010dose macrolides in chronic sinusitis: Systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0158-7638","authenticated-orcid":false,"given":"Kachorn","family":"Seresirikachorn","sequence":"first","affiliation":[{"name":"Department of Otolaryngology  Bangkok Thailand"},{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichana","family":"Suwanparin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanyanuch","family":"Srisunthornphanich","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9787-6767","authenticated-orcid":false,"given":"Wirach","family":"Chitsuthipakorn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Rajavithi Hospital Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2681-2958","authenticated-orcid":false,"given":"Dichapong","family":"Kanjanawasee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology  Bangkok Thailand"},{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7537-4718","authenticated-orcid":false,"given":"Kornkiat","family":"Snidvongs","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology  Bangkok Thailand"},{"name":"Endoscopic Nasal and Sinus Surgery Excellence Center King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,11]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"1","article-title":"European position paper on rhinosinusitis and nasal polyps 2012","volume":"23","author":"Fokkens WJ","year":"2012","journal-title":"Rhinol Suppl"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200847040-00001"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.12.1324"},{"key":"e_1_2_7_5_1","first-page":"CD011994","article-title":"Systemic and topical antibiotics for chronic rhinosinusitis","volume":"4","author":"Head K","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-013-0416-2"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-017-0696-z"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2015.08.014"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000191560.53555.08"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2011.02693.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21695_c"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.7544"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25052"},{"key":"e_1_2_7_14_1","unstructured":"HigginsJPT GreenS. 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