Perspective from Justin Kwan, OD, FAAO
Source/Disclosures
Disclosures: The authors report study funding from the Universidad Nacional de Colombia.
July 17, 2020
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Ivermectin-metronidazole therapy successful in treating blepharitis

Perspective from Justin Kwan, OD, FAAO
Source/Disclosures
Disclosures: The authors report study funding from the Universidad Nacional de Colombia.
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Ivermectin-metronidazole combined topical gel therapy successfully treated blepharitis caused by Demodex folliculorum infection, according to study results published in Contact Lens and Anterior Eye.

Demodex folliculorum is a microscopic, elongated mite, which is considered to be the most prevalent ectoparasite in humans. ... The eyelid can also be infected, leading to blepharitis,” Marcel Y. Avila, MD, PhD, department of ophthalmology, Universidad Nacional de Colombia, and colleagues wrote. “Numerous compounds have been described for the treatment of these infections. ... Development of a novel therapeutic approach to eradicate this mite with minimal adverse events and maximum tolerability is required.”

Avila and colleagues conducted a randomized clinical trial comprising 60 patients with diagnosed Demodex-associated blepharitis. They assigned patients to receive either topical ivermectin (0.1%)-metronidazole (1%) gel treatment or vehicle at day 0, day 15 and day 30. Researchers evaluated patients for the number of Demodex spp. mites found on the eyelashes as well as clinical improvement and adverse events.

Study results showed complete eradication of Demodex spp. in 96.6% of treatment group patients with decreases in Demodex count from day 15 to day 30 (P .001). Further, investigators also saw a statistically significant improvement in symptoms and reduction in redness in the treatment group (P .001). In the control group, there was no change in Demodex counts.

“This topical approach seems to be superior to systemic treatment, also having a better safety prole and posing less risk to patients,” Avila and colleagues concluded. “Application of this gel for the treatment of dierent parasitic infections of the eyelids could be feasible; this requires further exploration.”