Comparison of therapeutic effects of topical azithromycin solution and systemic doxycycline on posterior blepharitis

Abstract

Topical azithromycin could have similar effects as oral doxycycline on posterior blepharitis in improving subjective symptoms. However, doxycycline can reduce objective signs such as ocular surface staining and meibomian gland plugging more than azithromycin.

Comparison of a single-dose vectored thermal pulsation procedure with a 3-month course of daily oral doxycycline for moderate-to-severe meibomian gland dysfunction

“…The doxycycline outcomes in the current study were similar to those published previously. 12 – 16 Subjective symptom scores (assessed using different scales) have been reported to significantly improve following 3–4 weeks of doxycycline treatment regimens, using doses as high as 400 mg doxycycline per day. 14 – 16 In addition, daily administration of 200 mg oral doxycycline (100 mg BID for 1–2 months) has been found to improve meibomian gland secretion scores.…”

“… 12 – 16 Subjective symptom scores (assessed using different scales) have been reported to significantly improve following 3–4 weeks of doxycycline treatment regimens, using doses as high as 400 mg doxycycline per day. 14 – 16 In addition, daily administration of 200 mg oral doxycycline (100 mg BID for 1–2 months) has been found to improve meibomian gland secretion scores. 12 , 14 In this study, a standardized amount of pressure, approximating a deliberate blink, was applied over the glands as opposed to the more variable “mild” or “firm” pressure as described in other studies evaluating the benefits of treating MGD with doxycycline.…”

“…The mean ocular surface staining scores were found to improve significantly following doxycycline therapy (100 mg BID for 1 month). Regarding corneal staining, Zandian et al 16 reported significant improvement in the mean corneal staining scores with oral doxycycline therapy (100 mg daily for 3 weeks). Similarly, The mean corneal staining score improvement in the doxycycline group of the current study was not statistically significant.…”

“… 10 Antibiotic agents, including macrolides, and tetracycline and its derivatives have been shown to be beneficial for the management of various chronic inflammatory conditions, 11 and doxycycline is a long-acting analog of tetracycline that has been effectively used for the treatment of dry eye disease. 12 – 16 Its therapeutic efficacy has been attributed to various factors including its ability to inhibit the synthesis or activation of proinflammatory mediators in the corneal epithelium and its antimicrobial and antichemotactic properties, which leads to improvement in dry eye symptoms and tear film stability. 12 , 14 However, long-term use of doxycycline can be problematic due to the risk of side effects.…”

An eye for azithromycin: review of the literature

“…for 1 week and then once a day for 2 weeks, and in the other half orally DOX 100 mg for 3 weeks. Even though both treatments relieved signs and symptoms after 3 weeks, topical AZM was found more efficacious in alleviating eye redness, while oral DOX proved to be more potent in decreasing corneal staining and in the cure of meibomian glands plugging 21 ( Table 2 ). AZM is widely prescribed for MGD although it remains off-label, presumably to suppress the MGD-associated posterior blepharitis, the associated conjunctival inflammation, and growth of lid bacteria.…”