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Antibiotic treatment for dry eye disease related to meibomian gland dysfunction and blepharitis – A review
Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway.
Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway.
Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway; Department of Twin Research & Genetic Epidemiology, Kings College London, St Thomas Hospital, London, United Kingdom.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway.ORCID iD: 0000-0003-1079-4361
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2022 (English)In: Ocular Surface, ISSN 1542-0124, Vol. 26, p. 211-221Article, review/survey (Refereed) Published
Abstract [en]

Background: Dry eye disease (DED) is among the most prevalent ophthalmic conditions but is often underdiagnosed and mistreated. Antibiotics are regularly used to treat DED caused by meibomian gland dysfunction (MGD) or blepharitis, but their use has been questioned. Objective: To critically evaluate the use of oral and topical antibiotics in DED management. Methods: A literature search was conducted on November 15th, 2021, in the PubMed database. The search terms were: (antibiotics OR azithromycin OR doxycycline OR minocycline) AND (dry eye disease OR meibomian gland OR blepharitis anterior OR blepharitis posterior OR chronic blepharitis). All relevant original articles with English full-text were included. Case reports and review articles were excluded. Results: The search provided 619 articles, of which 22 met the inclusion criteria. Oral and topical antibiotics appeared to have short-term positive effects on signs and symptoms of blepharitis- or MGD-related DED. However, these improvements often reverted upon cessation of treatment. The need for repeated treatments and mild adverse events were common. Conclusions: Current evidence suggests that patients with blepharitis- or MGD-related DED experience short-term benefits of antibiotics. However, evidence for lasting improvement after completed treatment was lacking. Given the unclear long-term benefits, common side effects, and increasing antibiotic resistance seen globally, the existing literature is not sufficient to conclude that antibiotics are useful in long-term MGD management. A survival-analysis of a single round of antibiotics, in addition to the effects of repeated rounds of treatment, on DED parameters could provide useful insights. © 2022 Elsevier Inc.

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Elsevier Inc. , 2022. Vol. 26, p. 211-221
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URN: urn:nbn:se:liu:diva-193326DOI: 10.1016/j.jtos.2022.08.010PubMedID: 36210626Scopus ID: 2-s2.0-85139302690OAI: oai:DiVA.org:liu-193326DiVA, id: diva2:1754044
Available from: 2023-05-02 Created: 2023-05-02 Last updated: 2023-05-02

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Lagali, Neil S

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Division of Sensory Organs and CommunicationFaculty of Medicine and Health SciencesDepartment of Ophthalmology in Linköping
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