Fluoroquinolones compared to 1% azithromycin in DuraSite^® for bacterial conjunctivitis [from Lichenstein and Granet] and Response to correspondence [from Friedlaender and Protzko] ||FREE PAPER||

Steven J Lichtenstein¹, David B Granet²

¹Associate Clinical Professor of Pediatrics and Surgery, University of Illinois College of Medicine at Peoria and Chicago, Peoria, IL, USA, ²Anne F. Ratner Professor of Ophthalmology and Pediatrics, University of California at San Diego, San Diego, CA, USA

In a recent issue of Clinical Ophthalmology, Friedlaender and Protzko (2007) review the development and efficacy of 1% azithromycin in DuraSite^® (AzaSite™, Inspire Pharmaceuticals, Inc., Durham, NC) for the treatment of bacterial conjunctivitis. The authors conclude that 1% azithromycin in DuraSite offers a simplified dosing regimen with sustained bactericidal levels that decrease resistance development. While 1% azithromycin in DuraSite is a new formulation of azithromycin that allows topical ocular use, azithromycin and DuraSite have been around for many years. Evidence demonstrates a greater potential for emerging resistance with azithromycin, an older drug, especially when formulated in a vehicle that prolongs low levels of antibiotic exposure over time.

Mitchell H Friedlaender¹, Eugene Protzko²

¹Division of Ophthalmology, Scripps Clinic, 10666 N Torrey Pines Rd, La Jolla, CA, 92037 USA; ²Seidenberg Protzko Eye Associates, 930 Revolution St, Havre De Grace, MD, 21014 USA

In our review of the development and efficacy of 1% azithromycin in DuraSite^® (AzaSite™, InSite Vision, Alameda, CA, USA) published in Clinical Ophthalmology (Friedlaender and Protzko 2007), we describe azithromycin as a well known anti-infective agent with pharmacokinetic properties that were not sufficiently exploited for topical use in the eye until the development of AzaSite. A sustained release ocular antibiotic, AzaSite delivers sufficiently high concentrations of azithromycin to the eye to eradicate common causative pathogens of bacterial conjunctivitis. The means by which azithromycin is delivered to the eye in the AzaSite formulation gives it much greater tissue concentrations than expected.