NOSE AND PARANASAL SINUSES: Edited by Samuel S. Becker and Nithin D. AdappaWhat is the evidence for macrolide therapy in chronic rhinosinusitis?Cavada, Marina N.a,b; Grayson, Jessica W.c; Sacks, Raymonda,b,d,e Author Information aFaculty of Medicine and Health Sciences, Macquarie University bRhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales cDepartment of Otolaryngology Head and Neck Surgery, University of Alabama, Birmingham, Alabama, USA dFaculty of Medicine, University of Sydney eDepartment of Otolaryngology, Concord General Hospital, Sydney, New South Wales, Australia Correspondence to Marina N. Cavada, Faculty of Medicine and Health Sciences, Macquarie University, 3 Technology Place, Sydney 2109, NSW, Australia. E-mail: [email protected] Current Opinion in Otolaryngology & Head and Neck Surgery: February 2020 - Volume 28 - Issue 1 - p 6-10 doi: 10.1097/MOO.0000000000000593 Buy Metrics Abstract Purpose of review To assess the most recent evidence for macrolide therapy in chronic rhinosinusitis (CRS). Recent findings Macrolides play a significant role in a select group of patients with CRS. Low-serum and tissue eosinophilia in patients who do not respond to corticosteroid therapy appeared to be an effective predictor of a CRS phenotype suitable for a trial of long-term macrolide therapy. Therapies using half a dose for longer than 12 weeks have noted good outcomes. Summary The anti-inflammatory and immunomodulatory effects of macrolides have been demonstrated in several studies. Macrolides have shown an important role in patients who are nonresponsive to corticosteroid therapies, therefore patient selection is key. Previous inconsistencies in results may be due to poor patient selection. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.