Blepharitis medical therapy: Difference between revisions

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==Overview==
==Overview==
Eyelid hygiene and regular cleaning are the mainstay of therapy for blepharitis. Antimicrobial topic therapy may be indicated in some cases depending on the causative pathogen and the underlying cause.
Eyelid hygiene and regular cleaning are the mainstay of therapy for blepharitis.  
Antimicrobial topical therapy may be indicated in some cases depending on the causative pathogen and the underlying cause.


==Medical Therapy==
==Medical Therapy==

Revision as of 15:25, 13 July 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Eyelid hygiene and regular cleaning are the mainstay of therapy for blepharitis. Antimicrobial topical therapy may be indicated in some cases depending on the causative pathogen and the underlying cause.

Medical Therapy

Antimicrobial Regimens

  • 1. Empiric antimicrobial therapy[1]
  • Blepharitis
  • 2. Specific considerations
  • 2.1 Meibomian gland dysfunction:
  • Preferred regimen: Doxycycline 100 mg PO qd until clinical improvement followed by 40 mg PO qd for 2-6 weeks OR Minocycline 100 mg PO qd until clinical improvement followed by 50 mg PO for 2-6 weeks OR Tetracycline 1000 mg PO until clinical improvement followed by 250-500 mg PO qd for 2-6 weeks.
  • Alternative regimen (1): Erythromycin 250-500 mg PO qd for 3 weeks OR Azithromycin 250-500 mg PO 1-3 times a week for 3 weeks OR Azithromycin 1 g PO once per week for 3 weeks
  • Note: Tetracyclines are contraindicated among pregnant women, nursing women, and young children < 8 years of age
  • 2.2 Dry eye
  • Preferred regimen: Cyclosporine 0.05% ophthalmic emulsion bid for 6 months
  • 2.3 Ocular Rosacea
  • Preferred regimen: Doxycycline 100 mg PO qd until clinical improvement followed by 40 mg PO qd for 2-6 weeks OR Minocycline 100 mg PO qd until clinical improvement followed by 50 mg PO for 2-6 weeks OR Tetracycline 1000 mg PO until clinical improvement followed by 250-500 mg PO qd for 2-6 weeks OR (Azithromycin 250-500 mg PO 1-3 times a week for 3 weeks AND Tacrolimus 0.1% topical bid for 3 weeks) OR (Azithromycin 1 g PO once per week for 3 weeks AND Tacrolimus 0.1% topical bid for 3 weeks)
  • 3. Pathogen-directed antimicrobial therapy
  • 3.1 Staphylococcus spp.
  • 3.2 Demodex folliculorum
  • Preferred regimen: Metronidazole 2% gel bid for 1-2 weeks
  • Alternative regimen: Ivermectin 200 microgram/kg once weekly for 2 weeks

References

  1. "Blepharitis PPP 2013".

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