Efficacy of Oral Azithromycin Versus Doxycycline in Treatment of Meibomian Gland Dysfunction

Meibomian gland dysfunction (MGD) is usually treated with conservative methods. Adjunct therapy with oral Doxycycline has played a vital role in its treatment. Recently Azithromycin has also been introduced as a newer agent.

To compare the efficacy, safety and compliance of oral azithromycin with doxycycline over one year period in patients with Meibomian gland dysfunction (MGD).

A randomised comparative clinical trial was performed among 284 subjects (age >35 years) with MGD. They were randomly divided into two groups A and B. Along with standard conservative management, Group A received oral 9-day azithromycin (500 mg for 3 consecutive days for 3 consecutive weeks) and group B received 14 days doxycycline (200 mg/day). A score comprising seven symptoms and seven signs (primary outcome) was recorded before and at first and second follow up after treatment and further analyzed.

The mean symptoms and signs treated by Azithromycin group was lesser as compared to Doxycycline group in the first follow up (p <0.001). However it was statistically insignificant at second follow-up (p=0.043). The group taking azithromycin had a much better overall response (p = 0.006). Gastrointestinal symptoms were the major side effects encountered, the group taking doxycycline experienced significantly more side effects (p ≤0.001).

Both antibiotics were effective and safe for treating persistent MGD, but azithromycin was more effective. It required a lower dose, worked faster, and had a shorter treatment duration compared to doxycycline.