Researchers enrolled 26 eyes of 13 patients with posterior blepharitis diagnosed by a qualified ophthalmologist to evaluate the effects of oral azithromycin in this patient population.

They instructed patients to use oral azithromycin 500 mg per day for 3 days in 3 cycles with 7-day intervals and they graded and scored subjective clinical outcomes 1 day before and 30 days after the end of the treatment (53 days after initiating the treatment) based on severity scores of: 1) eyelid debris; 2) eyelid telangiectasia; 3) swelling of the eyelid margin; 4) redness of the eyelid margin; and 5) ocular mucus secretion. For the assessment of global efficacy, the researchers asked patients to rate the subjective symptoms (eyelid itching, ocular itching, eyelid hyperemia, ocular hyperemia, ocular mucus secretion, photophobia, foreign body sensation and dry eye sensation) on a scale of 0 (no symptoms) to 5 (severe symptoms). They also performed break-up time, Schirmer 1 test, corneal fluorescein staining score and rose bengal staining score in all patients.

According to the researchers, all clinical outcomes scoring showed statistically significant improvement after oral azithromycin, except for eyelid swelling. Average subjective symptom grading improved statistically after treatment with oral azithromycin, except for eyelid hyperemia, photophobia and foreign body sensation. Average tear film break-up time values showed statistically significant improvement after the treatment with oral azithromycin. Additionally, the researchers observed no statistically significant improvement on average values of Schirmer I test, corneal fluorescein staining score, and rose Bengal staining score.

This combination of multiple clinical parameters shown in this study supports the clinical efficacy of pulsed oral azithromycin therapy for the management of posterior blepharitis.

SOURCE: Igami TZ, Holzchuh R, Osaki TH, et al. Oral azithromycin for treatment of posterior blepharitis. Cornea. 2011;30(10):1145–1149.


COMMENT:  “I am optimistic that this regimen will work in synergy with the new Dry Eye program at Duke Eye Center that will include the latest technology from TearScience that includes the LipiView and LipiFlow units.” Alan N. Carlson, M.D.