Use of Azithromycin Ophthalmic Solution in the Treatment of Chronic Mixed Anterior Blepharitis

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Use of Azithromycin Ophthalmic Solution in the
Treatment of Chronic Mixed Anterior Blepharitis
Thomas John, MD (1) Ami A. Shah, BS MBB (2)
(1) Clinical Associate Professor, Loyola
University at Chicago, Maywood, Illinois, USA (2)
Rosalind Franklin University of Medicine
Science/Chicago Medical School, North Chicago,
Illinois, USA
tjcornea_at_gmail.com
ASCRS, San Francisco, CA, April 3-8, 2009
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Materials Methods

• Prospective, open-label study
• 150 eyes (75 patients) with clinical chronic
  mixed anterior blepharitis
• Average age of patients was 65.7 years 1.86
• Patients were treated for either 4 or 8 weeks
• 33 males and 42 females
• At the initial visit, all patients underwent a
  complete slit-lamp examination and the eyelids
  were evaluated
• Lids were evaluated for lid closure and blink
  patterns, apposition of eyelids, lid
  inflammation, and changes or disorders of the lid
  margin
• Patients were instructed to apply azithromycin
  ophthalmic solution on to their washed, clean
  index finger or to a clean applicator and then to
  apply the medication directly to the eyelids of
  both eyes, rather than using eye drops directly
  onto the ocular surface OU QHS
• Both eyes of each patient were treated with
  azithromycin ophthalmic solution (AzaSite 1,
  Inspire Pharmaceuticals, Durham, NC) or
  erythromycin ophthalmic ointment
• These patients were evaluated and treated with
• Azithromycin (67 patients, n134 eyes)
• Erythromycin (8 patients, n16)

John, T
ASCRS, San Francisco, CA, April 3-8, 2009
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Grading of Chronic Mixed Anterior Blepharitis
Grade Collarettes (Height in mm) Ulcerations (Percentage of Lid Margin) Matting Erythema (Percentage of Lid Margin)
1 (Trace) lt 1 10 0 lt 25
2 (Mild) 1 30 0 5 25 50
3 (Moderate) 2 50 6 10 50 75
4 (Severe) gt 2 gt50 gt 10 gt 75
Any three criteria/ Upper or Lower Lid
Patients with clinical resolution were graded 0
Mixed Seborrhic and Staphylococcal
John, T
ASCRS, San Francisco, CA, April 3-8, 2009
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Clinical Resolution by 4 weeks
The total clinical resolution after 4 weeks was
98.5 for the AzaSite treated group and 37.5
for the erythromycin treated group
ASCRS, San Francisco, CA, April 3-8, 2009
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Clinical Resolution by 8 weeks
The total clinical resolution after 8 weeks was
98.5 for the AzaSite treated group and 50 for
the erythromycin treated group
ASCRS, San Francisco, CA, April 3-8, 2009
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Summary

• In summary, this is the first study showing the
  clinical efficacy of using azithromycin
  ophthalmic solution (AzaSite 1, Inspire
  Pharmaceuticals, Durham, NC) directly on the
  eyelids for the effective treatment of chronic,
  mixed, anterior Blepharitis, with treatment times
  as short as 4 weeks

John, T
ASCRS, San Francisco, CA, April 3-8, 2009