Three weeks of oral azithromycin seems to be equivalent to six weeks of doxycycline for treatment of severe meibomian gland dysfunction (MGD), according to a study published online March 23 in JAMA Ophthalmology.
Phit Upaphong, M.D., from Chiang Mai University in Thailand, and colleagues conducted a randomized trial involving patients with moderate-to-severe MGD who were randomly assigned to receive oral azithromycin (1 g once per week for three weeks) or oral doxycycline (200 mg daily for six weeks). Overall, 137 eyes from 137 patients were randomly assigned to the azithromycin and doxycycline groups (68 and 69 eyes, respectively).
The researchers found that the adjusted mean between-group difference of total MGD scores was −0.33 and 0.13 at weeks 6 and 8, respectively. At six and eight weeks, the adjusted mean between-group difference in Ocular Surface Disease Index score was −1.20 and −1.59, respectively. Patients treated with azithromycin had fewer gastrointestinal adverse effects (4.4 versus 15.9 percent).
“The reduced dosing of azithromycin supports its use as an alternative to doxycycline for at least six weeks,” the authors write. “However, longer-term follow-up in each group would be needed to determine if these outcomes persist for this chronic condition.”
Phit Upaphong et al, Pulsed Oral Azithromycin vs 6-Week Oral Doxycycline for Moderate to Severe Meibomian Gland Dysfunction, JAMA Ophthalmology (2023). DOI: 10.1001/jamaophthalmol.2023.0302
B. Michele Melia, Evaluating the Evidence for Treatment of Meibomian Gland Dysfunction With Oral Antibiotics, JAMA Ophthalmology (2023). DOI: 10.1001/jamaophthalmol.2023.0320
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