Is AzaSite safe and useful longterm?

[Calathan]

My ophthalmologist prescribed me AzaSite as I was having eye pain, sensitivity to light, dry eyes, and a twitching eyelid.  He wants me to use it for a month, stop for a month, use it again for another month, stop for another month, and so on for an indeterminate amount of time.  He has said that in addition to being an antibiotic, it also has anti-inflammatory properties, and that it would help my eyes both by fighting any bacteria that gets into them and through the anti-inflammatory properties.

My pharmacist disagreed with him and said that AzaSite has no anti-inflammatory properties and that I shouldn't use it for more than 14 days.  My primary care doctor seemed to think that there wasn't any point to using AzaSite for more than 14 days, but didn't specifically say that I shouldn't.  Another issue is that it is rather expensive even with my insurance, so even if it is safe to use long term, if it isn't useful I wouldn't want to waste money on it.

My question is, is what my ophthalmologist saying correct?  I would think he would be better informed on eye medications than my pharmacist and my primary care doctor, but it is also possible he is misinformed or something.  Is it safe to use it in the way he prescribed, where I use it for a month at a time, then don't use it for a month, and repeat that multiple times?  Will taking a month off prevent any negative side effects that could otherwise occur from long term use?  And does it actually have any anti-inflammatory properties that will help even if I don't have an infection at the time?

[hansho]

Hi Calathan,
I can at least confirm that another ophthalmologist (Dr. John Hovanesian) also prescribes AZASITE  for repeat purposes to patients, specifically to those suffering  from hard-to-cure chronic blepharitis. Also, I can confirm that AZASITE (azythromyxcin) has excellent anti -inflammatory properties, because this is confirmed by various scientific studies.  
Calathan, if there are enough ophthalmologists who describe AZASITE on a maintenance purpose  for indefinite periods of time, then it becomes more credible that this should be OK. Below is a link to an article written by Dr. Hovenesian, in which you can read how he described AZASITE.
https://www.healio.com/ophthalmology/news/blogs/%7Bb1913218-61ae-4c6c-8e19-ef32fcf1515b%7D/john-a-hovanesian-md-facs/azithromycin--is-it-mothers-milk-for-blepharitis

[John C Hagan III, MD, FACS, FAAO]

Azasite is used for chronic blepharitis and meibomian gland disease (MGD) but it is not specificially approved for chronic use.  A much better and newer product for long term use (which I use myself)  is Avenova  spray. Does require a prescription.  Discount coupons available on manufactuers website which dramatically lower copays.

[Ray T Oyakawa, MD]

I usually prescribe this medication to be rubbed into lashes twice a day for two weeks for blepharitis.  Long term use may lead to bacterial resistance.

It does not have a steroid type of anti-inflammatory medication but has anti inflammatory properties.


http://www.eyeworld.org/ewweeksupplementarticle.php?id=318


Dr. O.