How often do you offer oral prescription antibiotic therapy to your meibomian gland dysfunction (MGD) patients? Many of us have become quite surprised by the effect we see in our dry eye disease (DED) patients we treat with oral OTC products e.g. Omega 3’s being the most common. But what about those patients that really have significant MGD and have tried warm compresses and topical artificial tears (AT)?
A publication in the British Journal of Ophthalmology Aug 2014 titled “Oral azithromycin versus doxycycline in meibomian gland dysfunction: a ramdomised double masked open label trial”, Kashkouli et al provide an excellent study comparing oral 5-day azithromycin (500 mg on day 1 and then 250 mg/day) or 1-month doxycycline (200 mg/day) who had failed to respond to prior conservative management. Patients were allowed to continue eyelid warming/cleaning and artificial tears. They looked at five symptoms and seven signs recorded prior to treatment then at 1 week, 1 and 2 months to evaluate efficacy and safety of these two drugs. We all struggle with patient compliance and if we can reduce frequency of any therapy whether in ocular surface disease (OSD),
Read the full results, here.