목적: The efficacy of macrolides in chronic rhinosinusitis (CRS) is still controversial. This study assessed to determine the effects of roxithromycin macrolide therapy on chronic sinusitis with nasal polyp after endoscopic sinus surgery (ESS). 방법:A retrospective chart review of 178 patients who underwent ESS for the treatment of CRS with nasal polyp was done. Patients were classified into 2 groups roxithromycin group (n=76) and non- roxithromycin group (n=102). Roxithromycin group had more than 8 weeks of roxithromycin. Non-roxithromycin group were treated mainly with cephalosporin. Both groups also had short-term use of steroid, without statistical significance in steroid use. Assessment was conducted before the surgery, 4 weeks after surgery and at the end point of medication, using a symptom questionnaire using visual analogue scale (VAS), sinonasal outcome test (SNOT)-20 and nasal endoscopic findings by Lund- Kennedy score. 결과:The average follow-up periods were 11.2 months in roxithromycin group and 5.7 months in non-roxithromycin group. Total nasal endoscopic score showed a statistically significant improvement in the roxithromycin group (2.68 → 1.91) compared to the non-roxithromycin group (2.33 → 2.18) (p=0.001). Especially, polyp grade showed a significant improvement (0.83 → 0.22 / 0.78 → 0.57) (p=0.019). Subgroup analysis showed that macrolide treatment more than 12 weeks had better improvement than those less than 12 weeks (p<0.05). However, there were no statistical differences in subjective nasal symptoms such as and quality of life score, SNOT-20 in all three domains. 결론:Roxithromycin treatment showed better outcome in endoscopic findings including polypoid changes although symptoms were similar between two groups. Therefore, roxithromycin long-term treatment could be a potential treatment modality after ESS in patients with nasal polyp.