Chronic rhinosinusitis with nasal polyps (CRSwNP) is a debilitating inflammatory condition characterized by a high recurrence rate despite standard medical and surgical interventions. Macrolide antibiotics, beyond their antimicrobial properties, exhibit potent immunomodulatory and anti-inflammatory effects. This article presents a prospective clinical study conducted at the Department of Otorhinolaryngology of Andijan State Medical Institute. Using the IMRAD framework, the research evaluates the clinical and endoscopic efficacy of a prolonged, twelve-week course of low-dose clarithromycin as an add-on therapy for patients with refractory CRSwNP. The study involved ninety adult patients, assessing outcomes through the Sino-Nasal Outcome Test (SNOT-22) and Lund-Kennedy endoscopic scores. The results demonstrate that patients receiving low-dose clarithromycin experienced a statistically significant reduction in polyp size, mucosal edema, and purulent discharge, alongside profound improvements in subjective quality of life compared to the placebo control group. The study concludes that prolonged low-dose macrolide therapy serves as a highly effective and safe conservative treatment modality, potentially reducing the need for repeated surgical interventions in patients with chronic polypoid sinonasal disease.

chronic rhinosinusitis, nasal polyps, clarithromycin, macrolides, immunomodulation, SNOT-22, Lund-Kennedy score.

Cervin, A., Kalm, O., Sandkull, P., & Lindberg, S. (2020). One-year low-dose erythromycin treatment of persistent chronic sinusitis after sinus surgery: clinical outcome and effects on mucociliary parameters and nasal nitric oxide. Otolaryngology–Head and Neck Surgery, 126(5), 481-489.

Fokkens, W. J., Lund, V. J., Hopkins, C., Hellings, P. W., Kern, R., Reitsma, S., ... & Zwura, J. (2020). European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology, 58(Suppl S29), 1-464.

Haxel, B. R., Clemens, M., Karaiskaki, N., Dippold, U., & Kettern, L. (2019). Efficacy of clarithromycin in chronic rhinosinusitis with and without nasal polyps: a randomized placebo-controlled trial. European Archives of Oto-Rhino-Laryngology, 276(5), 1361-1370.

Head, K., Chong, L. Y., Piromchai, P., Dawes, P., Schilder, A. G., Burton, M. J., ... & Philpott, C. (2018). Systemic and topical antibiotics for chronic rhinosinusitis. Cochrane Database of Systematic Reviews, (4).

Kanoh, S., & Rubin, B. K. (2021). Mechanisms of action and clinical application of macrolides as immunomodulatory medications. Clinical Microbiology Reviews, 23(3), 590-615.

Oakley, G. M., Harvey, R. J., & Lund, V. J. (2017). The role of macrolides in chronic rhinosinusitis. Current Allergy and Asthma Reports, 17(5), 30.

Wallwork, B., Coman, W., Mackay-Sim, A., Greiff, L., & Cervin, A. (2016). A double-blind, randomized, placebo-controlled trial of macrolide in the treatment of chronic rhinosinusitis. The Laryngoscope, 116(2), 189-193.

Mamadaliyevna, M. M. (2025). MEHNAT MUHOJIRLARI FARZANDLARINING YASHASH SHAROITLARI VA YANGI MUHITGA MOSLASHISH MUAMMOLARI (havo ifloslanishi, turli iqlim sharoitlari va boshqa omiillar tasiri). ИКРО журнал, 14(01), 51-53.

Mirzayeva, M. (2025). THE IMPACT OF NEGATIVE ATTITUDES FROM PEERS AND SOCIETY ON CHILDREN’S MENTAL AND PHYSICAL HEALTH. International journal of medical sciences, 1(1), 103-107.