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Long-term, Low-Dose Oral Azithromycin Treatment for Chronic Severe Bilateral Blepharokeratoconjunctivitis in
Insights
Oral azithromycin combined with topical treatments effectively manages chronic severe blepharokeratoconjunctivitis in children. This therapy significantly improved clinical signs and symptoms, offering a safe and effective long-term solution.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Pharmacology
Background:
- Chronic severe bilateral blepharokeratoconjunctivitis poses a significant challenge in pediatric eye care.
- Current treatment strategies often require multifaceted approaches to manage complex cases.
Purpose of the Study:
- To evaluate the efficacy and safety of oral azithromycin in combination with topical antibiotics and anti-inflammatory agents for pediatric chronic severe bilateral blepharokeratoconjunctivitis.
Main Methods:
- Retrospective review of pediatric patients (<14 years) with chronic severe bilateral blepharokeratoconjunctivitis treated with oral azithromycin (5 mg/kg/day) for ≥4 weeks.
- Assessment of clinical symptoms, corneal/conjunctival staining, corneal neovascularization, and meibomian gland function before and after treatment.
- Statistical comparison of clinical data at diagnosis and last follow-up (≥3 months post-treatment).
Main Results:
- Twenty-nine children (58 eyes) showed significant improvements in clinical symptoms, signs, and visual acuity post-treatment.
- Corneal staining, neovascularization, and meibomian gland dysfunction scores significantly improved (P < .001).
- No eyelid distortion or fornix shortening observed; patients maintained stability with daily eyelid hygiene and supportive topical therapy.
Conclusions:
- Long-term, low-dose oral azithromycin combined with topical agents is an effective and safe treatment for pediatric chronic severe bilateral blepharokeratoconjunctivitis.
- This therapeutic approach leads to substantial clinical improvement and long-term stability.
Purpose:
To evaluate the efficacy and safety of oral azithromycin treatment combined with topical antibiotic and anti-inflammatory agents in pediatric patients with chronic severe bilateral blepharokeratoconjunctivitis.
Methods:
Patients younger than 14 years with chronic and severe bilateral blepharokeratoconjunctivitis were reviewed retrospectively. Consecutive patients receiving oral azithromycin treatment were included. All patients received oral azithromycin (5 mg/kg/single dose daily) for at least 4 weeks combined with topical antibiotic and anti-inflammatory agents. Before and after the treatment, clinical symptoms were noted, and corneal and conjunctival fluorescein staining and corneal neovascularization were graded. Meibomian gland secretion and meibomian gland plugging were also assessed. All patients completed at least 3 months of follow-up after completion of the oral azithromycin treatment. Patients' clinical data at the time of diagnosis and last follow-up visit were statistically compared.
Results:
Twenty-nine children (58 eyes, mean age of 6.51 years) were included. The mean time of oral azithromycin use was 5.87 weeks (range: 4 to 10 weeks). Clinical symptoms and signs and visual acuity were significantly improved after treatment. The mean fluorescein staining and corneal neovascularization grades and meibomian gland secretion and meibomian gland plugging scores also improved after treatment (P < .001). Eyelid distortion or fornix shortening was not observed. At the last follow-up visit, all patients were stable with treatment only with daily eyelid hygiene, topical cyclosporine, and artificial tears.
Conclusions:
Long-term, low-dose oral azithromycin combined with topical antibiotic and anti-inflammatory agents is an effective treatment option for pediatric patients with chronic severe bilateral blepharokeratoconjunctivitis. [.
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