Oral azithromycin versus doxycycline in meibomian gland dysfunction: A hospital-based study at Nepal eye hospital

Background: Meibomian gland dysfunction (MGD) involves posterior blepharitis, which includes a disruption of the tear and meibum lipids and thereby produces an evaporative dry eye. The most common cause is obstruction of the meibomian glands, which causes inflammatory changes and increases bacterial...

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Main Authors: Sabita Dhakal, Sabina Shrestha, Pooja Karki, Sujata Dhakal
Format: Article
Language:English
Published: Manipal College of Medical Sciences, Pokhara 2025-04-01
Series:Asian Journal of Medical Sciences
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Online Access:https://ajmsjournal.info/index.php/AJMS/article/view/4441
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author Sabita Dhakal
Sabina Shrestha
Pooja Karki
Sujata Dhakal
author_facet Sabita Dhakal
Sabina Shrestha
Pooja Karki
Sujata Dhakal
author_sort Sabita Dhakal
collection DOAJ
description Background: Meibomian gland dysfunction (MGD) involves posterior blepharitis, which includes a disruption of the tear and meibum lipids and thereby produces an evaporative dry eye. The most common cause is obstruction of the meibomian glands, which causes inflammatory changes and increases bacterial colonization along the lid margins. Conservative management consists of warm compresses, mechanical eyelid massage, and artificial tears; when severe, an oral antibiotic with anti-inflammatory properties can be suggested. Aims and Objectives: The aims and objectives of the study are to compare the effects (symptom and sign scores) and safety (side effects) of oral azithromycin compared with oral doxycycline in patients with posterior blepharitis. Materials and Methods: This is a prospective, comparative, and randomized hospital-based study conducted at Nepal Eye Hospital from June 2016 to December 2017. This study recruited patients having severe MGD. Convenience sampling technique was used for the selection of patients. Result: A total of 60 patients with 30 in each group ranging in age from 21 to 74 years were included. Both groups experienced a significant improvement in symptoms and indicators (P=0.001). Ocular surface staining (P=0.04) and bulbar conjunctival redness (P=0.02) were significantly better in the azithromycin group, but symptom improvement was not different between the groups. When the doxycline group experienced more side effects in the 3rd week, there was no discernible difference in the mild gastrointestinal side effects between the groups. Conclusion: This study showed that oral doxycycline and azithromycin are beneficial to patients with MGD patients. Due to superior clinical improvement, shorter treatment duration, low cost, and side effects, 5-day oral azithromycin is recommended in comparison to 1-month oral doxycycline.
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spelling doaj-art-a8ba5eeea1604f2c9730f156fdc1537e2025-08-20T02:53:58ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-04-011648489https://doi.org/10.71152/ajms.v16i4.4441Oral azithromycin versus doxycycline in meibomian gland dysfunction: A hospital-based study at Nepal eye hospitalSabita Dhakal 0https://orcid.org/0009-0008-6532-781XSabina Shrestha 1https://orcid.org/0000-0002-7272-3617Pooja Karki 2https://orcid.org/0000-0001-8399-8926Sujata Dhakal3https://orcid.org/0009-0003-3207-3386Vitreo Retina Surgeon, Lumbini Eye Institute and Research Centre, Bhairahawa, Nepal Professor, Department of Pediatric Ophthalmology and Strabismus, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal Associate Professor, Department of Oculoplasty, Nepal Academy of Medical Sciences, Nepal Eye Hospital, Kathmandu, Nepal Graduate, Department of Community Health Sciences and Public Health, School of Public Health, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal Background: Meibomian gland dysfunction (MGD) involves posterior blepharitis, which includes a disruption of the tear and meibum lipids and thereby produces an evaporative dry eye. The most common cause is obstruction of the meibomian glands, which causes inflammatory changes and increases bacterial colonization along the lid margins. Conservative management consists of warm compresses, mechanical eyelid massage, and artificial tears; when severe, an oral antibiotic with anti-inflammatory properties can be suggested. Aims and Objectives: The aims and objectives of the study are to compare the effects (symptom and sign scores) and safety (side effects) of oral azithromycin compared with oral doxycycline in patients with posterior blepharitis. Materials and Methods: This is a prospective, comparative, and randomized hospital-based study conducted at Nepal Eye Hospital from June 2016 to December 2017. This study recruited patients having severe MGD. Convenience sampling technique was used for the selection of patients. Result: A total of 60 patients with 30 in each group ranging in age from 21 to 74 years were included. Both groups experienced a significant improvement in symptoms and indicators (P=0.001). Ocular surface staining (P=0.04) and bulbar conjunctival redness (P=0.02) were significantly better in the azithromycin group, but symptom improvement was not different between the groups. When the doxycline group experienced more side effects in the 3rd week, there was no discernible difference in the mild gastrointestinal side effects between the groups. Conclusion: This study showed that oral doxycycline and azithromycin are beneficial to patients with MGD patients. Due to superior clinical improvement, shorter treatment duration, low cost, and side effects, 5-day oral azithromycin is recommended in comparison to 1-month oral doxycycline.https://ajmsjournal.info/index.php/AJMS/article/view/4441meibomian gland dysfunction; meibum lipids; azithromycin; doxycycline
spellingShingle Sabita Dhakal
Sabina Shrestha
Pooja Karki
Sujata Dhakal
Oral azithromycin versus doxycycline in meibomian gland dysfunction: A hospital-based study at Nepal eye hospital
Asian Journal of Medical Sciences
meibomian gland dysfunction; meibum lipids; azithromycin; doxycycline
title Oral azithromycin versus doxycycline in meibomian gland dysfunction: A hospital-based study at Nepal eye hospital
title_full Oral azithromycin versus doxycycline in meibomian gland dysfunction: A hospital-based study at Nepal eye hospital
title_fullStr Oral azithromycin versus doxycycline in meibomian gland dysfunction: A hospital-based study at Nepal eye hospital
title_full_unstemmed Oral azithromycin versus doxycycline in meibomian gland dysfunction: A hospital-based study at Nepal eye hospital
title_short Oral azithromycin versus doxycycline in meibomian gland dysfunction: A hospital-based study at Nepal eye hospital
title_sort oral azithromycin versus doxycycline in meibomian gland dysfunction a hospital based study at nepal eye hospital
topic meibomian gland dysfunction; meibum lipids; azithromycin; doxycycline
url https://ajmsjournal.info/index.php/AJMS/article/view/4441
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