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Efficacy of azithromycin 1.5% eyedrops vs oral doxycycline in meibomian gland dysfunction: a randomized trial

  • Medical Ophthalmology
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Abstract

Purpose

To determine the efficacy of azithromycin 1.5% eyedrops compared with oral doxycycline in patients with moderate to severe meibomian gland dysfunction (MGD).

Methods

This prospective randomized trial included 169 participants with newly diagnosed moderate to severe MGD. Participants were randomly assigned to treatment with azithromycin 1.5% eyedrops (n = 85) twice daily for 2 days then once daily until 4 weeks or oral doxycycline (n = 84) 100 mg twice daily for 4 weeks. Signs and symptoms of MGD were evaluated at baseline and 4 weeks later. The percentages of participants with improvement in meibum quality were assessed as a primary outcome. Secondary outcomes were MGD-related symptoms, meibum expressibility, Oxford ocular surface staining score, tear film break up time (TBUT), and drug side effects.

Results

Although there were significant improvements in all outcomes in both groups, there was no between-group differences in the percentages of participants with improved meibum quality (P = 0.80), MGD-related symptoms (P > 0.05), meibum expressibility (P = 0.92), Oxford ocular surface staining score (P = 0.59), and TBUT (P = 0.99). Five (5.88%) participants in azithromycin group and four (4.76%) participants in doxycycline group discontinued medications due to drug side effects (P = 0.75).

Conclusions

Both azithromycin 1.5% eyedrops and oral doxycycline significantly improved signs and symptoms in patients with moderate to severe MGD. Both azithromycin 1.5% eyedrops and oral doxycycline showed no difference in term of improved signs and symptoms of MGD as well as drug side effects that lead to discontinuation of medication.

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Funding

This study was funded by the Rachadaphiseksomphot Endowment Fund of Chulalongkorn University (RA57/061).

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama 4 road, Bangkok, 10330, Thailand

    Vannarut Satitpitakul, Kitiya Ratanawongphaibul, Ngamjit Kasetsuwan & Usanee Reinprayoon

Authors
  1. Vannarut Satitpitakul
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  2. Kitiya Ratanawongphaibul
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  3. Ngamjit Kasetsuwan
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  4. Usanee Reinprayoon
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Correspondence to Vannarut Satitpitakul.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Satitpitakul, V., Ratanawongphaibul, K., Kasetsuwan, N. et al. Efficacy of azithromycin 1.5% eyedrops vs oral doxycycline in meibomian gland dysfunction: a randomized trial. Graefes Arch Clin Exp Ophthalmol 257, 1289–1294 (2019). https://doi.org/10.1007/s00417-019-04322-1

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  • DOI: https://doi.org/10.1007/s00417-019-04322-1

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