Which form of azithromycin is indicated for blepharitis or bacterial conjunctivitis?

• A. Oral Azithromycin (Z-pack) for chlamydia
• B. Topical Azithromycin for blepharitis/bacterial conjunctivitis
• C. Oral Azithromycin for blepharitis
• D. Topical Azithromycin is not used in ocular infections

Answer: (B)

Topical azithromycin delivers the antibiotic directly to the surface of the eye, achieving high local concentrations where blepharitis and bacterial conjunctivitis occur while minimizing systemic exposure. The ophthalmic 1% solution is indicated for acute bacterial conjunctivitis and is also used for blepharitis, targeting the common eyelid-margin bacteria that drive this condition. Its convenient short course and good penetration into eyelid tissues make it especially suitable for blepharitis, where localized treatment is preferred. Systemic (oral) azithromycin is reserved for infections requiring whole‑body therapy, such as chlamydial conjunctivitis, and is not the standard approach for localized ocular surface infections.