Comparison of therapeutic effects of topical azithromycin versus topical azithromycin with systemic doxycycline on posterior blepharitis

Abstract

Purpose The aim of this study was to compare the therapeutic effects of topical azithromycin versus topical azithromycin with systemic doxycycline on posterior blepharitis. Patients and methods This is a prospective comparative study that was performed on 80 eyes of 40 patients with posterior blepharitis. The patients were divided into two groups: group A included the patients who received a 1-week topical azithromycin 1.5% solution twice a day, followed by another 1-week topical azithromycin 1.5% solution once daily, while group B included the patients who received the same regimen with additional oral doxycycline 100 mg once a day for 3 weeks. All patients were examined by the slit lamp for lid collarettes, lid redness, plugging of meibomian gland orifices, and tear breakup time after 1 week, 1 month, and 3 months. Results Before treatment, there were no statistically significant difference between the two groups regarding the symptoms and signs. After treatment, all symptom and sign scores were decreased compared with the baseline scores. Group B patients significantly improved more than group A patients after 1 month ( P =0.002) and after 3 months ( P =0.001) regarding the symptoms and most of the signs [lid collarettes after 1 month ( P =0.013), lid redness after 1 month ( P =0.009), and after 3 months ( P =0.002), plugging of meibomian gland orifices after 1 month ( P =0.001) and after 3 months ( P >0.001), tear breakup time after 1 month ( P =0.001) and after 3 months ( P =0.004), and corneal staining after 1 month ( P =0.001) and after 3 months ( P >0.001)]. Only concerning lid collarettes, the difference in improvement between the two groups was insignificant after 3 months ( P =0.177). Conclusion Adding systemic doxycycline with topical azithromycin to the management plan of posterior blepharitis were found to be more superior than using topical azithromycin alone.