Evaluation of effectiveness and tolerance of treatment with Azithromycin 1.5% eye drops in bacterial conjunctivitis

Introduction
Azithromycin is a macrolide class antibiotic, recently adapted for topical use in ophthalmology. It is effective against the most frequent pathogens found in bacterial conjunctivitis, Gram positive and Gram negative bacteria, Azithromycin has the specificity to have sustained high tissue levels: after repeated instillation, it has been shown to reach sustained concentrations above the MICs of susceptible bacteria for 4 days in tears and for 7 days in conjunctiva. The aim of study: To investigate the effectiveness and tolerance of treatment with Azithromycin 1.5% eye drops in bacterial conjunctivitis.

Material and methods
The prospective study included 40 patients (69 eyes) with purulent bacterial conjunctivitis; aged 21-70 years; average: 38.05. Patients were treated with 1.5% azithromycin eye drops topically twice-dai ly for 3 days. Conjunctival swabbing were taken at the 1st and the 7th ±1 day of the treatment. Effectiveness and tolerance of eye drops were assessed in 7th ±1day from the beginning of the treatment.

Results
Bacteriological cultures were positive before treatment in 34 eyes (49.28%), negative – 35 eyes (50.72%). In 69 eyes with bacterial conjunctivitis the following microorganisms were identyfied (34 eyes): Streptococcus pneumoniae 23.53% (8 eyes), Staphyllococcus aureus 23.53% (8 eyes), Staphyllococcus epidermidis 20.59% (7 eyes), Haemophilus influenzae 17.65% (6 eyes), Morganella Morgani 2.94% (1 eye), Proteus mirabilis 2.94% (1 eye), Enterococcus species 2.94% (1 eye), Streptococcus viridians 2.94% (1 eye), Moraxella (Branhamella) catarrhalis 2.94% (1 eye). Positive bacteriological culture at the 7th day of treatment – 2 eyes (1 eye – Staphyllococcus epidermidis MSCNS, 1 eye – Morganella Morgani). Clinical recovery or significant improvement were observed in 68 of 69 evaluated eyes.

Conclusions
Three-day topical therapy with azithromycin 1.5% eye drops is an effective and well tolerated therapy for purulent bacterial conjunctivitis.