Navigating Presbyopia Conversations with Patients in Practice
Optometry 360
Home > Topical azithromycin shows benefit in mixed dry eye disease

Topical azithromycin shows benefit in mixed dry eye disease

Optometry 360

Key Takeaways

  1. Topical azithromycin significantly improved symptoms and several objective measures of mixed dry eye disease.
  2. Findings support further study of azithromycin as a second-line treatment, although larger randomized studies are needed to confirm the results.

Topical azithromycin ophthalmic solution (Azyter, 15 mg/g) significantly improved disease symptoms and signs as second-line treatment for mixed dry eye disease (DED), according to a study.

The prospective controlled pilot study included 15 patients with mixed DED refractory to first-line treatment. Patients were treated with topical azithromycin for 30 days (twice daily for 3 days, then once daily for 27 days). Ten healthy individuals were included as controls. Patients were evaluated before and after treatment in the study group and once in controls.

Following treatment, DEQ-5 scores improved significantly (P < 0.001) and were no longer significantly different from those of controls. Schirmer test results and non-invasive tear break-up time also increased significantly (P = 0.003 and P = 0.027, respectively), reaching levels comparable to controls.

Significant improvements were also observed in blepharitis (P < 0.001), meibomian gland dysfunction (P < 0.001), and corneal fluorescein staining scores (P = 0.002), as well as maximum corneal epithelial thickness (P = 0.037).

The authors concluded that second-line treatment with topical azithromycin improved mixed DED symptoms and signs, but larger randomized studies are needed to confirm these findings.

Reference

Cestnik B, Dovžak Fritz A, Bone T, et al. Treatment of Mixed Dry Eye Disease with Topical Azithromycin: A Prospective Controlled Pilot Study. J Clin Med. 2026;15(19):7549. doi: 10.3390/jcm15197549. PMID: 42882011; PMCID: PMC13665977.

Related Content