Effectiveness, tolerability and safety of azithromycin 1% in DuraSite® for acute bacterial conjunctivitis

PURPOSE Bacterial eye infections are commonly treated with topical antibiotics, despite limited evidence of effectiveness. Azithromycin 1% in DuraSite((R)) is a new formulation of azithromycin in a gel polymer designed for use in acute bacterial conjunctivitis. METHODS We conducted systematic searches of the Cochrane Database of Clinical Trials, PubMed and Google Scholar to find randomized controlled trials of "azithromycin DuraSite((R))". These searches of published literature were supplemented with searches for unpublished trials and trials in progress. RESULTS We found six reports of randomized controlled trials investigating the role of azithromycin 1% in DuraSite((R)) for the management of acute bacterial conjunctivitis. The quality of these trials was judged to be moderate to high. These trials assessed effectiveness, tolerability and safety outcomes, but we found no trials looking at cost-effectiveness. DuraSite((R)) is a relatively stable formulation and so azithromycin 1% in DuraSite((R)) has a simpler dosing schedule than other available topical antibiotics. It appears to be similar to other topical antibiotics in its effectiveness, but minor side effects are quite common. CONCLUSION Acute bacterial conjunctivitis is a relatively mild, typically self-limiting, infection. Antibiotics should seldom be required. If, however, a decision to prescribe antibiotics is made, azithromycin 1% in DuraSite((R)) is likely to be broadly comparable in its effectiveness to most other antibiotics used to treat acute bacterial conjunctivitis. Further research is needed to determine its cost-effectiveness.