Azithromycin works against meibomian gland dysfunction

Topical and oral azithromycin present effective options for the treatment of meibomian gland dysfunction (MGD), reports a recent meta-analysis.

Searching through the databases of PubMed, OVID Medline, ClinicalTrials.gov, Embase, and the Cochrane Library, researchers retrieved 18 studies eligible for the quantitative analysis of the primary outcome, improvement in symptom score.

Overall, azithromycin led to a significant improvement in symptom scores at the end of follow-up, according to pooled analysis (standardized mean difference [SMD], 1.54, 95 percent confidence interval [CI], 1.15–1.92).

Disaggregating according to formulation, researchers saw that both oral (SMD, 1.64, 95 percent CI, 0.87–2.42) and topical (SMD, 1.49, 95 percent CI, 1.02–1.96) azithromycin were significantly effective against MGD.

Azithromycin similarly demonstrated significant efficacy in terms of secondary MGD outcomes, such as pooled lid debris, lid swelling, and lid redness. The same was true for meibum quality, plugging of the meibomian gland, and conjunctival injection. Objective measurements, such as lissamine green staining and tear break-up time, likewise reflected the significant activity of azithromycin against MGD.

In terms of safety, the combined occurrence rate of adverse events after topic azithromycin was 25 percent. Ocular discomfort was a common theme of the side effects, such as redness, blurred vision, and an irrigation sensation. In comparison, oral azithromycin led to a 7-percent pooled rate of adverse events, including effects on the gastrointestinal system. There were no severe systemic complications reported.