Doxycycline
Doxycycline is an antibiotic that can also suppress cytokines, chemokines and remodeling factors 128-131. Two small randomized controlled trials on Western CRSwNP patients (80-90% T2) indicated modest polyp shrinkage and symptom improvement with doxycycline, possibly by preventing enhancement of T2 responses byStaphylococcus aureus 71,132-134. Based on these data, a role for doxycycline in the management of T2 CRSwNP has been proposed. Mechanistic studies on doxycycline are unclear, however, and a later clinical study indicated that low T2 biomarkers in CRSwNP patients were predictors of a clinical response135-137.