Skip to main content Accessibility help

The anti-inflammatory effects of erythromycin, clarithromycin, azithromycin and roxithromycin on histamine-induced otitis media with effusion in guinea pigs

  • B Ersoy (a1), B Aktan (a2), K Kilic (a3), M S Sakat (a2) and S Sipal (a4)...



Otitis media with effusion is a clinical manifestation characterised by inflammation of middle-ear mucosa. This study investigated the therapeutic effect of erythromycin, clarithromycin, azithromycin and roxithromycin on a histamine-induced animal model of otitis media with effusion.


The animals were divided into five groups, receiving erythromycin, clarithromycin, azithromycin, roxithromycin or saline solution. The guinea pigs in the study groups received erythromycin (40 mg/kg/day), clarithromycin (15 mg/kg/day), azithromycin (10 mg/kg/day) or roxithromycin (10 mg/kg/day) for 3 days by gastric tube. Four hours after the end of the administration, histamine solution was injected into the right middle ear.


The lowest neutrophil density value obtained using stereological techniques was in the azithromycin group (0.86 ± 0.25 × 10−5/μm3), while the highest value was observed in the control group (6.68 ± 3.12 × 10−5/μm3). The anti-inflammatory properties of clarithromycin, azithromycin and roxithromycin were similar to one another, but better than that of erythromycin.


The use of macrolide antibiotics is recommended, as they show antibacterial and anti-inflammatory efficacy in otitis media with effusion.


Corresponding author

Address for correspondence: Dr Korhan Kilic, Department of Otolaryngology, Regional Training and Research Hospital, Erzurum, Turkey E-mail:


Hide All

Dr K Kilic takes responsibility for the integrity of the content of the paper



Hide All
1Aktan, B, Gundogdu, C, Ucuncu, H, Unal, B, Sütbeyaz, Y, Altas, S. Anti-inflammatory effect of erythromycin on histamine-induced otitis media with effusion in guinea pigs. J Laryngol Otol 2004;118:97101
2Iino, Y, Sugita, K, Toriyama, M, Kudo, K. Erythromycin therapy for otitis media with effusion in sinobronchial syndrome. Arch Otolaryngol Head Neck Surg 1993;119:648–51
3Culic, O, Erakovic, V, Parnham, MJ. Anti-inflammatory effects of macrolide antibiotics. Eur J Pharmacol 2001;429:209–29
4Cervin, A. The anti-inflammatory effect of erythromycin and its derivatives, with special reference to nasal polyposis and chronic sinusitis. Acta Otolaryngol 2001;121:8392
5Aktan, B, Taysi, S, Gumustekin, K, Bakan, N, Sutbeyaz, Y. Evaluation of oxidative stress in erythrocytes of guinea pigs with experimental otitis media and effusion. Ann Clin Lab Sci 2003;33:232–6
6Kozan, G, Aktan, B, Sakat, MS, Kurt, S, Öner, F, Kara, A. Effect of systemic clarithromycin and prednisolone on histamine-induced otitis media in guinea pigs. Acta Otolaryngol 2015;135:978–84
7Taysi, S, Ucuncu, H, Elmastas, M, Aktan, B, Emin, Buyukokuroglu M. Effect of melatonin on lipid peroxidation, glutathione and glutathione-dependent enzyme activities in experimental otitis media with effusion in guinea pigs. J Pineal Res 2005;39:283–6
8Nonaka, M, Pawankar, R, Tomiyama, S, Yagi, T. A macrolide antibiotic, roxithromycin, inhibits the growth of nasal polyp fibroblasts. Am J Rhinol 1999;13:267–72
9Tamaoki, J, Kadota, J, Takizawa, H. Clinical implications of the immunomodulatory effect of macrolides. Am J Med 2004;117:511
10Yamamoto, K, Arakawa, T, Ueda, N, Yamamoto, S. Transcriptional roles of nuclear factor-κB and nuclear factor-interleukin-6 in the tumor necrosis factor-α dependent induction of cyclooxygenase-2 in MC3T3-E1 cells. J Biol Chem 1995;270:31315–20
11Ianaro, A, Ialenti, A, Maffia, P. Anti-inflammatory activity of macrolide antibiotics. J Pharmacol Exp Ther 2000;292:156–63
12Li, Y, Azuma, A, Takahashi, S. Fourteen-membered ring macrolides inhibit vascular cell adhesion molecule 1 messenger RNA induction and leukocyte migration: role in preventing lung injury and fibrosis in bleomycin-challenged mice. Chest 2002;122:2137–45
13Suzuki, H, Asada, Y, Ikeda, K, Oshima, T, Takasaka, T. Inhibitory effect of erythromycin on interleukin-8 secretion from exudative cells in the nasal discharge of patients with chronic sinusitis. Laryngoscope 1999;109:407–10
14Miyanohara, T, Ushikai, M, Matsune, S. Effects of clarithromycin on cultured human nasal epithelial cells and fibroblast. Laryngoscope 2000;110:126–31
15Labro, MT, el Benna, J, Babin-Chevaye, C. Comparison of the in vitro effect of several macrolides on the oxidative burst of human neutrophils. J Antimicrob Chemother 1989;24:561–72



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed