The experience with the application of Azidrop in the ophthalmological practice

Introduction. The infectious inflammatory diseases of the eyes are characterized by the high prevalence and the potential risk of impairment of visual acuity. Background. It is widely known that the uncontrollable use of antibacterial medications is a major cause of the growing resistance of microorganisms to antibiotic agents. The use of the highly efficient preparations that have never before been employed for the local application in the ophthalmological practice as the basic ingredients for the development and production of the novel eye drops appears to be a very promising area for the further work. One of such medications is an Azidrop ophthalmic solution containing azithromycin at a concentration of 15 mg/g. Aim. The objective of the present study was to evaluate the clinical and antimicrobial effectiveness of the Azidrop ophthalmic solution for the treatment of the inflammatory diseases of the bacterial nature. Materials and methods. A total of 46 patients including 25 children and 21 adults (72 eyes) who presented with the inflammatory diseases of the anterior segment of the eye were available for the examination. All the patients were treated with the use of the Azidrop ophthalmic solution twice daily during 3 days. Sowing of microbial flora contained in the discharge from the conjunctival cavity was done before and after the course of therapy to estimate its sensitivity to antibiotics. Moreover, we evaluated the symptoms of inflammation based on the 4-point scale and performed biomicroscopy of the cornea and conjunctiva using fluorescein sodium and lissamine green as staining solutions. Changes in the symptoms of inflammation were repeatedly evaluated on days 5 and 7 after the initiation of therapy. Results. The microorganisms were identified in 87.5% of the primary isolates from the conjunctival cavity contents. Three days after the onset of therapy using the Azidrop ophthalmic solution, the positive results of microbiological analysis were obtained only in 19.5% of the patients as appeared from the total disappearance of Staphylococcus aureus and hemoliticus, Streptococcus viridans, and Enterococcus. All the patients exhibited the tendency toward alleviation of the inflammatory reaction of the conjunctiva and reduction of the amount of discharge from the conjunctival cavity as early as the second day of the treatment. The clinical recovery and improvement of the eyes’ condition was documented in 52.8% and 44.4% of the patients respectively within 5 days after the onset of therapy (i.e. 2 days after its termination). 80.6% of the patients experienced clinical recovery and 18.1% improvement of the eyes’ conditions 4 days after the withdrawal of the Azidrop ophthalmic solution. These observations give evidence of the prolonged action of the Azidrop ophthalmic solution. An even faster dynamics of cessation of discharge from the conjunctival cavity was recorded. It was virtually absent in 75.5% and 94.4% of the patients on days 5 and 7 from the onset of therapy respectively. Discussion. Our experience with the application of the Azidrop ophthalmic solution in the ophthalmological practice confirmed that azithromycin is possessed of the high antimicrobial activity with respect to the most common bacterial pathogens responsible for the development of the inflammatory eye diseases as revealed by the microbiological methods. It can be argued that even a short course of therapy with azithromycin produces an excellent clinical effect and is fairly well tolerated by the patients. Moreover, the prolonged action and beneficial effect of this antibiotic on the state of corneal epithelium have been demonstrated. Conclusion. 1. The treatment of the inflammatory diseases of the anterior segment of the eye with the Azidrop ophthalmic solution containing 15 mg/g of azithromycin produces the well pronounced clinical effect. 2. The Azidrop ophthalmic solution-based preparations can be recommended for the wide application in the pediatric ophthalmological practice for the management of the infectious diseases of the anterior segment of the eye. This treatment can be prescribed to the patients within the first year after birth.