Background: Chronic rhinosinusitis (CRS) is a heterogeneous, multifactorial inflammatory disease of the nose and Paranasal sinuses, Chronic rhinosinusitis (CRS) affects around 5–15% of the European and American population, which makes it a common health problem that makes significant costs for health systems and state economies, phenotype classification of CRS with polyposis (CRSwNP) and without polyposis (CRSsNP).

Methods: A prospective, comparative randomized study was done in ENT Center, Sulaymania Teaching Hospital and Middle East ENT Head and Neck Surgery private center from October 2018 to October 2019. Sixty Patients presented with (CRSwNP) refractory to the maximal medical treatment and listed for FESS with informed consent included in the current study. The patients were randomly divided into two groups, each group included 30 patients, Group A; were Macrolide (clarithromycin 250mg /d/ 3m) prescribed postoperatively, Group B; without Macrolide. Both groups were topographic data collected preoperatively and clinical assessment pre and post-operatively at 1, 3, 6 months done utilizing the Lund-Kennedy Score (LKS), Lund-Mackay Score (LMS) and Sino-Nasal Outcome Test (SNOT 20) scores.

Results: The study established ability of short term low dose Clarithromycin treatment after FESS, throughout improving of the Lund-Kennedy Score (LKS), Lund-Mackay Score (LMS) and Sino-Nasal Outcome Test (SNOT 20) scores in group A in comparison to the control group B.

Conclusion: 3 months post FESS macrolide is able to control the inflammatory condition and inhibit the recurrence of the nasal polyposis after FESS.

Keywords:Chronic rhinosinusitis, Nasal polyposis, Endoscopic sinus surgery, Clarithromycin