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  • By Michael G. Haas, MD
    Comprehensive Ophthalmology

    This double-masked, randomized study found that both oral azithromycin and oral doxycycline improved symptoms in patients with meibomian gland dysfunction, but the authors recommend azithromycin. 

    Investigators assigned 110 patients who had failed to respond to conservative management to either 5-day oral azithromycin or 1-month oral doxycycline. All subjects continued eyelid cleaning and artificial tears.

    Both treatments improved disease symptoms after 2 months of follow-up, but the azithromycin group showed significantly better overall clinical response (P=0.01), more improvement in bulbar conjunctival redness (P=0.004) and ocular surface staining (P=0.01), and fewer side effects.

    The authors recommend a 5-day course of azithromycin based on these findings, as well as the shorter treatment duration and lower cost associated with azithromycin.

    Question: Given that treatment duration is shorter and costs are comparable or favorable for azithromycin, will you consider switching from doxycyline to azithromycin for your meibomian gland dysfunction patients who do not respond to conservative treatment?