3-week azithromycin on par with 6-week doxycycline for treating MGD

In the treatment of moderate-to-severe meibomian gland dysfunction (MGD), a 3-week course of oral azithromycin leads to outcomes that are similar to that achieved with a 6-week course of oral doxycycline, according to a study.

The study included 137 eyes from 137 patients (mean age 62.0 years, 66.4 percent women) with moderate-to-severe MGD deemed unresponsive to conservative management. These patients were randomly assigned to receive treatment with either oral azithromycin (1 g once per week for 3 weeks; n=68) or oral doxycycline (200 mg daily for 6 weeks; n=69).

Researchers evaluated the total MGD score and Ocular Surface Disease Index (OSDI) score at the initial visit, at 6 weeks, and at 8 weeks. Adverse events (AEs) were assessed also at weeks 6 and 8.

The adjusted mean difference of total MGD scores between the azithromycin and doxycycline groups was −0.33 (95 percent confidence interval [CI], −1.70 to 1.03; p=0.01 for equivalence) at week 6 and 0.13 (95 percent CI, −1.59 to 1.84; p=0.02 for equivalence) at week 8.

The adjusted mean difference of OSDI scores between the two treatment groups was −1.20 (95 percent CI, −5.31 to 2.91; p<0.001 for equivalence) at week 6 and −1.59 (95 percent CI, −5.73 to 2.55; p<0.001 for equivalence) at week 8.

Furthermore, participants treated with azithromycin vs doxycycline had significantly fewer gastrointestinal AEs (4.4 percent vs 15.9 percent; risk difference, 11.5 percent, 95 percent CI, 1.6–21.4; p=0.03).

In light of the results, the reduced dosing and potentially fewer gastrointestinal AEs associated with azithromycin support its use as an alternative to doxycycline for at least 6 weeks.