Renteria AE, Maniakas A, Mfuna LE, et al. - Since it is suspected that the sinonasal microbiome plays an important role in the pathophysiology of refractory chronic rhinosinusitis (CRS), researchers assessed changes in the microbiome following a 4‐month course of low‐dose azithromycin. The assessment of microbiome alterations after such treatment can help to identify the underlying mechanisms of this drug. In total, 48 adults with refractory CRS were recruited. Study participants were randomized to 250 mg of azithromycin or placebo 3 times weekly for 4 months. According to this double‐blind, randomized, placebo‐controlled trial, a 4‐month 250 mg course of azithromycin 3 times weekly in patients with refractory CRS significantly reduces Staphylococcus aureus abundance in the sinonasal microbiome. Considering the pathogenic function of S. aureus in the refractory CRS population, azithromycin may provide an additional therapeutic choice to help control this disease.