Comparison of the Clinical Efficacy of Topical and Systemic Azithromycin Treatment for Posterior Blepharitis

Yıldız, Elvin; Yenerel, Nursal Melda; Turan-Yardimci, Ayca; Erkan, Murat; Güneş, Pembegül

doi:10.1089/jop.2017.0095

Cited by 24 publications

(47 citation statements)

References 26 publications

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“…Five RCTs were conducted to evaluate the effects of azithromycin ophthalmic solutions for resolving ocular signs and symptoms due to different eye diseases. Four of the five studies took subjects with blepharitis (7,(17)(18)(19) and one study reported the effect of azithromycin on patients with papulopustular rosacea (8). The efficacy of azithromycin on different clinical signs and symptoms is presented as follows.…”

Section: Study Description Of Included Studiesmentioning

confidence: 99%

“…Four of the studies (7,8,17,19) reported the clinical efficacy of Azithromycin ophthalmic solutions in improving eyelid finding scores. The standardized mean difference of these studies indicates that there is statistically significant improvement in the severity of eyelid finding scores (RR = -1.94; 95%…”

Section: Eyelid Finding Scoresmentioning

confidence: 99%

“…Blepharitis, meibomian gland dysfunction and other ocular diseases lead to dry eye due to decreased secretions (20)(21)(22). Three RCTs (17,18,19) was found to report the effect of azithromycin in improving meibomian gland secretion. The pooled estimate of the studies revealed that patients treated with Azithromycin showed statistically significant improvement in meibomian glad secretion (RR = -1.78; 95% CI: -2.25, -1.30) ( Fig.…”

Section: Meibomian Gland Secretionmentioning

confidence: 99%

“…Fluorescein and rose Bengal dyes have been reported to be advantageous for measuring ocular surface staining scores (23). Four studies (7,8,18,19) evaluated the efficacy of azithromycin ophthalmic solutions on ocular surface staining scores and the overall result indicated that azithromycin is effective in improving the staining scores due to some disease with (RR = -0.57; 95%…”

Section: Ocular Surface Staining Scoresmentioning

confidence: 99%

“…The outline of hyperemia often appears with the greatest redness at the fornices and declines moving toward the limbus (26). Three studies (7,8,19) reported the effect of Azithromycin eye drops for conjunctival hyperemia due to different eye diseases. The pooled estimate of these studies indicates azithromycin ophthalmic solutions were effective in decreasing conjunctival hyperemia with (RR = -1.09; 95% CI: -1.49, -0.69) ( Fig.…”

Section: Conjunctival Hyperemiamentioning

confidence: 99%

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Efficacy of Azithromycin 1% and 1.5% ophthalmic solutions compared to tobramycin 0.3% eye drops: A systematic review and meta-analysis

Motbaynor

Kassie

2020

Preprint

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Background: Azithromycin 1% and 1.5% ophthalmic preparations are used widely in clinical practice for the treatment of signs and symptoms of eye diseases. Despite individual studies, there have been no summarized evidence about the efficacy of azithromycin over tobramycin eye drops. Therefore, the aim of this study was to abridge this gap by rendering conclusive evidence by comparing the efficacy of azithromycin 1% and 1.5% over tobramycin 0.3% ophthalmic solutions for the treatment of eye diseases in short duration in terms of bacterial resolution, cure rate and resolving clinical sign and symptoms of eye diseases. Methods: Systematic searches were performed in both electronic (Medline (Ovid), EMBASE (Ovid), Emcare (Ovid), CINAHL (EBSCOhost), Scopus, PubMed, ProQuest, Web of Science and Cochrane Central Register of Controlled Trials) and other sources (Worldcat, Mednar, Google and Google scholar). Multicenter randomized controlled trial studies conducted in the English language were identified and screened. Joanna Briggs Institute quality assessment checklist for randomized controlled trials was used to critically appraise the methodological quality of studies. Analysis of individual studies was conducted using the OpenMeta-analyst and Review manager Version 5.3 software. The study was reported, according to the PRISMA reporting checklist. Results: Eleven studies were included in the systematic review and meta-analysis. In clinical cure rate, Azithromycin 1% and 1.5% eye drops were more effective than tobramycin 0.3% eye drops in short duration dosing (≤ 5 days) with a twice-a-day regimen (RR=1.138; 95% CI:1.008, 1.284) whereas on increased duration (>5days) azithromycin is almost similarly as effective as tobramycin with (RR=1.007; 95% CI: 0.964, 1.052). There was no significant difference in efficacy of bacterial resolution of azithromycin (1%, 1.5%) eye drops compared to tobramycin (0.3%) eye drops (RR=0.992; 95% CI: 0.967, 1.0183). Conclusion: Azithromycin 1% and 1.5% eye drops are more effective in clinical cure rate than tobramycin 0.3% eye drops for short duration treatment. So that it is recommended to use azithromycin instead of tobramycin eye drops to get good result in short duration dosage. Systematic Review Registration ID : CRD42019139911, registered on October 16,2019; https://www.crd.york.ac.uk/PROSPERO/#recordDetails Keywords: Azithromycin, Tobramycin, Efficacy, Eye drops, Eye diseases

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Section: Study Description Of Included Studiesmentioning

confidence: 99%

Section: Eyelid Finding Scoresmentioning

confidence: 99%

Section: Meibomian Gland Secretionmentioning

confidence: 99%

Section: Ocular Surface Staining Scoresmentioning

confidence: 99%

Section: Conjunctival Hyperemiamentioning

confidence: 99%

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Efficacy of Azithromycin 1% and 1.5% ophthalmic solutions compared to tobramycin 0.3% eye drops: A systematic review and meta-analysis

Motbaynor

Kassie

2020

Preprint

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Pulsed Oral Azithromycin vs 6-Week Oral Doxycycline for Moderate to Severe Meibomian Gland Dysfunction

2023

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ImportanceThe treatment of moderate to severe meibomian gland dysfunction (MGD) with oral doxycycline requires a 6-week course of treatment and has frequent adverse effects (AEs), which may be associated with poor compliance.ObjectiveTo determine if the AEs of a 3-week course of oral azithromycin were equivalent to the AEs of a 6-week course of oral doxycycline.Design, Setting, and ParticipantsThis double-masked randomized clinical trial was conducted at a referral center in Thailand from September 2018 to May 2022. Participants with moderate to severe MGD judged unresponsive to conservative management were included.InterventionsPatients were randomized 1:1 to receive oral azithromycin (1 g once per week for 3 weeks) or oral doxycycline (200 mg daily for 6 weeks).Main Outcomes and MeasuresAfter initiating therapy, the study team assessed the total MGD score and Ocular Surface Disease Index (OSDI) score at the initial visit, at 6 weeks, and at 8 weeks, and assessed AEs at 6 weeks and 8 weeks. The prespecified equivalence margins for MGD score and OSDI score were set at ±2 and ±9, respectively.ResultsA total of 137 eyes from 137 patients were randomized into groups, 68 eyes in the azithromycin group and 69 eyes in the doxycycline group (female, 66.4%; mean age, 62.0 [SD, 15.1] years). The adjusted mean difference of total MGD scores between groups at week 6 and week 8 were −0.33 (95% CI, −1.70 to 1.03; P for equivalence = .01) and 0.13 (95% CI, −1.59 to 1.84; P for equivalence = .02), respectively. The adjusted mean difference of OSDI between groups score at week 6 and week 8 was −1.20 (95% CI, −5.31 to 2.91; P for equivalence &lt; .001) and −1.59 (95% CI, −5.73 to 2.55; P for equivalence &lt; .001), respectively. In addition, patients treated with azithromycin had fewer gastrointestinal AEs (4.4% vs 15.9%; risk difference, 11.5%; 95% CI 1.6%-21.4%; P = .03).Conclusions and RelevanceThese data support an equivalency of effects of azithromycin as compared with doxycycline for MGD score and OSDI score at both follow-up times. The study did not show more gastrointestinal AEs in the azithromycin group. The reduced dosing and potentially fewer gastrointestinal AEs associated with azithromycin support its use as an alternative to doxycycline for at least 6 weeks.Trial RegistrationThaiClinicalTrials.org Identifier: TCTR20180810001

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A Bioequivalence Study With Pharmacokinetic Endpoints for Azithromycin Eye Drops

Zhao

Guo

et al. 2023

Clinical Pharm in Drug Dev

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Azithromycin eye drops with a bioadhesive ocular drug‐delivery system can offer a simplified dosing regimen. In this study, we compared the pharmacokinetic properties and assessed the bioequivalence of a newly developed generic azithromycin eye drop with a branded formulation. This open‐label, single‐dose, randomized, crossover, sparse‐sampling ocular bioequivalence study was conducted on 48 healthy Chinese volunteers. Tear samples were collected for up to 36 hours, and each participant was randomly allocated to one of the prespecified sampling times. Tear drug concentrations were determined using a validated liquid chromatography‐tandem mass spectrometry method. The pharmacokinetic parameters were calculated via noncompartmental analysis. A nonparametric bootstrap method was used to obtain 90% confidence intervals (CIs) for the ratios of the test and reference drugs. Tolerability was evaluated for adverse events (AEs). After bootstrapping (1000 iterations), the 90%CIs for the log‐transformed ratios of Cmax, AUC0‐t, and AUC0–∞were within the acceptable bioequivalence range (80%–125%). No moderate‐to‐severe AEs were reported for either formulation. Bioequivalence was demonstrated between the two formulations. The sparse‐sampling design with the bootstrapping technique is promising for bioequivalence studies of topical ophthalmic drugs.

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Comparison of the Clinical Efficacy of Topical and Systemic Azithromycin Treatment for Posterior Blepharitis

Abstract: Although both treatment methods are found to be effective, the results of topical treatment group showed some superiority over those of systemic treatment group, which may be associated with a higher ocular tissue concentration of azithromycin after topical administration.

Cited by 24 publications

References 26 publications

Efficacy of Azithromycin 1% and 1.5% ophthalmic solutions compared to tobramycin 0.3% eye drops: A systematic review and meta-analysis

Efficacy of Azithromycin 1% and 1.5% ophthalmic solutions compared to tobramycin 0.3% eye drops: A systematic review and meta-analysis

Pulsed Oral Azithromycin vs 6-Week Oral Doxycycline for Moderate to Severe Meibomian Gland Dysfunction

A Bioequivalence Study With Pharmacokinetic Endpoints for Azithromycin Eye Drops

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