title: Oral azithromycin for treatment of posterior blepharitis.
abstract: OBJECTIVE
  To evaluate the effects of oral azithromycin in patients with posterior blepharitis.
  
  
  METHODS
  Twenty-six eyes of 13 patients with posterior blepharitis diagnosed by a qualified ophthalmologist were enrolled in this study. Patients were instructed to use oral azithromycin 500 mg per day for 3 days in 3 cycles with 7-day intervals. Subjective clinical outcomes were graded and scored 1 day before and 30 days after the end of the treatment (53 days after initiating the treatment) based on severity scores of: (1) eyelid debris; (2) eyelid telangiectasia; (3) swelling of the eyelid margin; (4) redness of the eyelid margin; and (5) ocular mucus secretion. For the assessment of global efficacy, patients were asked by the investigator to rate the subjective symptoms (eyelid itching, ocular itching, eyelid hyperemia, ocular hyperemia, ocular mucus secretion, photophobia, foreign body sensation, and dry eye sensation) on a scale of 0 (no symptoms) to 5 (severe symptoms). Break-up time, Schirmer I test, corneal fluorescein staining score, and rose bengal staining score were also performed in all patients.
  
  
  RESULTS
  All clinical outcomes scoring showed statistically significant improvement after oral azithromycin, except for eyelid swelling. Average subjective symptom grading improved statistically after treatment with oral azithromycin, except for eyelid hyperemia, photophobia, and foreign body sensation. Average tear film break-up time values showed statistically significant improvement after the treatment with oral azithromycin. No statistically significant improvement was observed on average values of Schirmer I test, corneal fluorescein staining score, and rose bengal staining score.
  
  
  CONCLUSIONS
  The combination of multiple clinical parameters shown in this study supports the clinical efficacy of pulsed oral azithromycin therapy for the management of posterior blepharitis.
authors.affiliation: Department of Ophthalmology, Hospital das Clínicas of Universidade de São Paulo (USP), Sao Paulo, Brazil.
authors.forename: Thais Zamudio
authors.initials: TZ
authors.lastname: Igami
authors.forename: Ricardo
authors.initials: R
authors.lastname: Holzchuh
authors.forename: Tammy Hentona
authors.initials: TH
authors.lastname: Osaki
authors.forename: Ruth Miyuki
authors.initials: RM
authors.lastname: Santo
authors.forename: Newton
authors.initials: N
authors.lastname: Kara-Jose
authors.forename: Richard Y
authors.initials: RY
authors.lastname: Hida
mesh_terms: D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D001762:Blepharitis / Q000188:drug therapy* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008537:Meibomian Glands / Q000187:drug effects* / Q000382:microbiology; D008875:Middle Aged; D011446:Prospective Studies; D011537:Pruritus / Q000188:drug therapy / Q000503:physiopathology; D020551:Pulse Therapy, Drug; D013666:Tears / Q000737:chemistry; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin