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The clinical efficacy of erythromycin (EM), EM's derivatives, clarithromycin (CAM) and roxithromycin (RXM) on chronic sinusitis has been demonstrated in numerous reports. However, a comparison of the relative clinical efficacy of EM, CAM and RXM remains unstudied. In this study, the clinical efficacy of EM and CAM in the treatment of chronic sinusitis was compared.EM and CAM were randomly assigned to patients using the envelope method. Adults were given a total of 600mg of EM administered as three doses daily, or 400mg of CAM administered as two doses daily. Children were given 10-15mg/kg of EM as three doses daily or 200mg of CAM as two doses daily, when body weight exceeded 30kg, and 100mg of CAM as two doses when body weight was less than 30kg. Treatment was principally limited to EM or CAM oral administration.Clinical efficacy was assessed by symptoms and rhinoscopic findings after 12 weeks administration. The results were as follows. Nineteen of 28 (67.9%) adults treated with CAM and 8 of 21 (38.1%) adults given EM demonstrated improvement. In children, 13 of 17 (76.5%) CAM patients and 6 of 15 (40.0%) EM patients demonstrated improvement. In both adults and children, a significant difference between CAM group and EM group was shown by the goodness of fit test using chisquare analysis. It was concluded that the clinical efficacy of CAM exceeded that of EM in the treatment of chronic sinusitis.

Clinical Efficacy of Long-Term Macrolides Therapy for Chronic Sinusitis. Comparison between Erythromycin and Clarithromycin.