1 Department of Ophthalmology, Haydarpasa Numune Egitim ve Arastirma Hastanesi , Istanbul, Turkey .
2 Ministry of Health, Tunceli State Hospital , Tunceli, Turkey .
J Ocul Pharmacol Ther. 2018 May;34(4):365-372. doi: 10.1089/jop.2017.0095. Epub 2018 Mar 1.
To compare the clinical efficacy of topical and oral azithromycin treatments for posterior blepharitis.
Both topical and oral treatment groups comprised 15 patients. In the topical group, azithromycin 15 mg/g ophthalmic solution (Azyter; Thea Pharmaceuticals, Clermont-Ferrand, France) was used twice a day for 3 days and then once a day until the treatment completes a month. In the systemic treatment group, azithromycin 250 mg tablets (Azitro; Deva Pharmaceuticals, Istanbul, Turkey) were used, 1 × 2 tablets (500 mg) at the first day of treatment and then 1 × 1 tablet (250 mg) for 4 days. Three cycles of treatment with 5-day intervals were completed. The ocular symptoms, eyelid margin sings, Ocular Surface Disease Index (OSDI), tear film break-up time, corneal/conjunctival staining score, Schirmer test, and conjunctival brush cytology were evaluated at baseline, 1, and 5 weeks after the end of treatment.
Both topical azithromycin and oral azithromycin were found to be effective in improving the clinical signs and symptoms of posterior blepharitis. The mean OSDI scores, lissamine green staining scores, and Schirmer test results showed improvements after both topical and oral treatments. However, topical treatment was shown to be associated with longer cytological improvements that persist at least 5 weeks and with better stabilization of the tear film, which is well documented by showing longer tear film break up time (TFBUT) in the topical treatment group.
Although both treatment methods are found to be effective, the results of topical treatment group showed some superiority over those of systemic treatment group, which may be associated with a higher ocular tissue concentration of azithromycin after topical administration.
比较局部和口服阿奇霉素治疗后部睑缘炎的临床疗效。
局部治疗组和口服治疗组各 15 例。局部治疗组使用 15mg/g 阿奇霉素滴眼剂（Azyter；法国克莱蒙费朗的 Thea 制药公司），每天两次，共 3 天，然后每天一次，直到治疗完成一个月。全身治疗组第一天使用阿奇霉素 250mg 片剂（Azitro；土耳其伊斯坦布尔的 Deva 制药公司），每次 2 片（500mg），然后连续 4 天每天 1 片（250mg）。共完成 3 个 5 天疗程。在治疗前、治疗结束后 1 周和 5 周评估眼部症状、睑缘体征、眼表疾病指数（OSDI）、泪膜破裂时间、角膜/结膜染色评分、泪液分泌试验和结膜刷细胞学。
局部和口服阿奇霉素均能有效改善后部睑缘炎的临床体征和症状。OSDI 评分、荧光素染色评分和泪液分泌试验结果均显示两种治疗方法均有改善。然而，局部治疗与更长时间的细胞学改善相关，并且至少在 5 周内稳定泪膜，这通过显示局部治疗组的泪膜破裂时间（TFBUT）更长得到充分证明。
虽然两种治疗方法均有效，但局部治疗组的结果显示出一些优势，这可能与局部给药后阿奇霉素在眼部组织中的浓度更高有关。
