Treatment of adenotonsillar hypertrophy: A prospective randomized trial comparing azithromycin vs. fluticasone

The aim of this study was to compare the efficacy of azithromycin vs. fluticasone in treatment of adenotonsillar hypertrophy (AH). In a clinical trial, 39 AH patients were selected using convenience time-based sequential sampling method. The subjects were randomized into two treatment groups. Patients in group A (fluticasone) and B (azithromycin) were respectively treated with fluticasone spray and azithromycin suspension for a 6-week period. Data regarding the grade of obstruction (based on tonsillar size), level of adenotonsillar hypertrophy, and obstructive sleep apnoea (OSA) symptoms (including mouth breathing, snoring, hyponasal speech, and sleep apnoea) were collected by a self-administrated questionnaire before treatment, as well as 1 week and 8 weeks after treatment. Twenty AH patients in group A and 19 AH patients in group B were studied. AH related symptoms, including mouth breathing, snoring, hyponasal speech and sleep apnoea, improved significantly in both groups (p < 0.05). We also found a statistically significant reduced grade of obstruction among patients in both groups. However, fluticasone was not effective on adenotonsillar hypertrophy. One week after treatment, outcomes related to apnoea and hyponasal speech were better in group B than group A. Decreases in mouth breathing and snoring were not significantly different between group A and B. Azithromycin seems to be more effective than fluticasone in improving AH-related symptoms.