title: Oral Antibiotics for Meibomian Gland-Related Ocular Surface Disease: A Report by the American Academy of Ophthalmology.
abstract: OBJECTIVE
  To review the existing medical literature on the role of oral antibiotics in the management of ocular surface disease (OSD) that arises from disorders of the meibomian glands and to assess the efficacy of oral antibiotics in the management of this common ocular disease.
  
  
  METHODS
  A literature search was last conducted on August 12, 2015, in the PubMed and Cochrane databases for English-language original research investigations that evaluated the role of doxycycline, minocycline, and azithromycin in OSD among adult patients. The searches identified 87 articles, and 8 studies ultimately met the criteria outlined for this assessment.
  
  
  RESULTS
  The 8 studies identified in the search documented an improvement in meibomian gland-related OSD after treatment with these agents, although side effects were common. This search identified only 1 randomized, controlled trial to assess the efficacy of these medications.
  
  
  CONCLUSIONS
  Although oral antibiotics are used commonly in the management of OSD, there is no level I evidence to support their use. There are only a few studies that have assessed the efficacy of oral antibiotics in clinically meaningful ways in the management of OSD that arises from disorders of the meibomian glands. The current level of evidence is insufficient to conclude that antibiotics are useful in managing OSD arising from disorders of the meibomian glands. The few existing studies on the topic indicate that oral antibiotics may be an effective treatment for OSD that results from meibomian gland disease.
authors.affiliation: Ophthalmic Plastic Surgery, Department of Ophthalmology, Albany Medical Center, Albany (Slingerlands), New York.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Wladis
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Bradley
authors.affiliation: Wills Eye Hospital, Philadelphia, Pennsylvania.
authors.forename: Jurij R
authors.initials: JR
authors.lastname: Bilyk
authors.affiliation: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Yen
authors.affiliation: Vanderbilt Eye Institute, Vanderbilt University, Nashville, Tennessee.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Mawn
mesh_terms: D000047:Academies and Institutes / Q000458:organization & administration; D000284:Administration, Oral; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004318:Doxycycline / Q000627:therapeutic use; D005141:Eyelid Diseases / Q000188:drug therapy*; D006801:Humans; D008537:Meibomian Glands / Q000187:drug effects*; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use; D009885:Ophthalmology / Q000458:organization & administration; D013673:Technology Assessment, Biomedical; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin; D008911:Minocycline; D004318:Doxycycline