The bacteria that cause endophthalmitis and other post-op infections typically originate in the lid margin flora, so the overgrowth of bacteria that characterizes untreated blepharitis can significantly increase patients’ risk of post-op infectious complications. Data on file: study report 041-104.Copyright © 2020 EyeWorld News Service. He thinks this suggests that AzaSite is effective as a topical treatment for blepharitis.Downsides to the use of AzaSite appear to be few. Abstract presented at the Association for Research in Vision and Ophthalmology 2008 Annual Meeting held April 27-May 1, 2008, in Fort Lauderdale, Fla. John T, Shah AA. I also recommended (and still recommend) that blepharitis patients increase their consumption of While traditional treatment of blepharitis often provides at least some improvement in symptoms, the ideal treatment would address the infectious as well as the inflammatory aspects of the disease. In the recent review article, Dr. Luchs considered the rationale for potentially using AzaSite in the treatment of blepharitis. Warm compresses, lid scrubs, and other agents (including doxycycline, cyclosporine emulsion, and artificial tears) may provide added treatment benefit, depending on the type of blepharitis and the presence or absence of concurrent dry eye disease.Whatever treatment methods are selected for a particular patient, the availability of a new, highly effective antibacterial drug offers a valuable opportunity to refocus attention on this common condition.
After just 2 weeks of therapy, investigators found a significant reduction in lid margin disease and degree of meibomium gland plugging, as well as a significant improvement in the quality of meibomium gland secretions. Many patients have “mixed blepharitisj,” i.e.
They also found that in the group treated with AzaSite, 82% of patients rated the efficacy of their therapy as good or excellent versus just 18% of those who used warm compresses alone.Another study considered here, this one conducted by Gary Foulks, M.D., also indicated that patients had significant improvement in signs and symptoms of posterior blepharitis with the use of AzaSite. – Warm compresses for 1 to 5 minutes (the longer the better) BID followed by - Lid hygiene twice a day, using a dedicated lid-cleansing agent – Azithromycin one drop OU BID for two days then QD for 28 days (for severe cases, I recommend one month on and one month off of this regimen, indefinitely) I also recommend that the bottle be kept upside down in a shot glass, as this keeps the viscous solution in the tip of the bottle so that patients won’t struggle to deliver the drop If the patients complain of stinging upon instillation, I ask them to keep the bottle in the refrigerator, as the cold temperature decreases this sensation– Oral tetracyclines for more severe cases of posterior blepharitis; I recommend 100 mg PO BID for 7 to 10 days, followed by 20 mg PO QD for 3 to 4 months at least; some patients are on 20 mg indefinitely.
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Because this drug remains active in the lid margin tissues for extended periods, it provides the long-term antibacterial and anti-inflammatory effect that blepharitis treatment requires. Qualified patients then randomly receive oral azithromycin (2 of 250 mg capsules for the first day and 250mg for the next 4 days) or oral doxycycline (100mg capsule every 12 hours for one month) in a double-blinded fashion.
And the most widely used ophthalmic antibiotics, the fluoroquinolones, are not anti-inflammatory.A new ophthalmic formulation of azithromycin could overcome these obstacles. As we all know, some patients reject antibiotic ointment therapy.
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