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Jonathan B. Greene, Todd P. Margolis, Robert Fintelmann, Bennie H. Jeng; Oral Azithromycin for the Treatment of Meibomitis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):606.
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Despite its robust antimicrobial and anti-inflammatory properties, favorable ocular pharmacokinetics, and relatively safe side-effect profile, oral azithromycin has not been systematically evaluated for the treatment of meibomitis. This study was designed to evaluate for symptomatic improvement after treatment with oral azithromycin in patients with meibomitis who have failed traditional treatments.
We retrospectively reviewed the charts of all patients with meibomitis recalcitrant to standard treatment modalities who were given oral azithromycin (1 gram orally once per week for 3 weeks) as part of their treatment regimen. Data recorded included patient demographics, prior failed treatments, concurrent treatments, subjective improvement after azithromycin treatment, and reported adverse effects.
A total of 32 patients with meibomitis underwent treatment with oral azithromycin. Seventy-five percent (75%) of patients receiving oral azithromycin reported improvement in their symptoms at follow-up (average time to follow-up 5.6 weeks). Though all patients received concurrent steroid therapy, when controlling for those who had previously failed steroids, 64% still reported improvement. No significant adverse effects attributable to azithromycin were reported.
Oral azithromycin may be a useful therapy for treating meibomitis, particularly in patients who have failed traditional therapies. We propose that its well documented anti-inflammatory and antimicrobial properties contribute to this effect, and azithromycin’s ocular pharmacokinetics allow for a much simpler and shorter dosing regimen than other frequently used medications. Further investigation is warranted.
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