Observational Comparative Study to Evaluate The Efficacy of Oral Azithromycin and Oral Doxycycline in Management of Meibomian Gland Dysfunction

Abstract

Introduction: “Meibomian gland dysfunction (MGD) is thought to be the leading cause of dry eye disease”.(1) The pathophysiology of MGD is complex and bacterial infection is a cause of MGD remains controversial. “Doxycycline is a long acting analogue of tetracycline which has been used to treat MGD through its antimicrobial, anti-inflammatory and anti metalloproteinase properties, with fewer side effects than tetracycline”.(2,3) This comparative and clinical study is being done to evaluate efficacy and compliance of oral doxycycline and oral azithromycin in meibomian gland dysfunction who were not responding to conservative management. Methods: The study was carried out from April 2016 to September 2016 in our institute. 100 patients were enrolled in the study. Thorough ophthalmic examination was done. Schirmer tests 1 and 2 and TBUT (tear film break up time) were performed to check for dry eye. Patients were called for 3 follow-up and whole ophthalmic examinations were repeated each time. Results: Total 100 patients were included in the study. Of these 59 males and 41 were females. In both group signs and symptoms improvement from pretreatment to last follow up was statistically significant (p=0.000). Improvement of symptoms and signs in both group was almost equal, so p-value is insignificant, when comparing between both groups (p=0.714). The side effects in doxycycline group was more as compared to azithromycin group at all follow up (p=0.012). Conclusion: This study demonstrated that both oral doxycycline and azithromycin are effective in patients with MGD. The side effects observed in doxycycline group were significantly higher in all follow up visits as compared to azithromycin group. Therefore, a five day course of oral azithromycin is suggested based on better clinical improvement, shorter treatment duration, less side effects and low cost.