{ "schema_version": 1, "kind": "condition", "id": "blepharitis", "name": "Chronic blepharitis", "category": "chronic", "sources": "AAO Blepharitis Preferred Practice Pattern 2018 · Blepharitis - StatPearls - NCBI Bookshelf - disease-level clinical article (blepharitis-full.txt) · Bacitracin Ophthalmic Ointment USP, US prescribing information, INDICATIONS AND USAGE and DOSAGE AND ADMINISTRATION (DailyMed SetID 6ed2f2bd-9d2f-46af-a44c-95a02ca034de) · Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph)", "review_status": "reviewed", "verified_against": "AAO Blepharitis Preferred Practice Pattern 2018 · Blepharitis - StatPearls - NCBI Bookshelf - disease-level clinical article (blepharitis-full.txt) · Bacitracin Ophthalmic Ointment USP, US prescribing information, INDICATIONS AND USAGE and DOSAGE AND ADMINISTRATION (DailyMed SetID 6ed2f2bd-9d2f-46af-a44c-95a02ca034de) · Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph)", "verified_date": "2026-08", "treatments": [ { "id": 308, "generic": "Bacitracin", "line": 1, "is_adjunct": false, "form": "eye", "strength_mg": null, "adult_dose": "Clean off all scales and crusts first, then spread the ointment evenly along the lid margins, 1 to 3 times daily", "adult_duration": "2 to 8 weeks", "dose_source": "Blepharitis - StatPearls - NCBI Bookshelf - disease-level clinical article (blepharitis-full.txt) - verbatim, for the indication and the course: \"Antibiotic creams such as bacitracin or erythromycin can be applied to the lid margin for 2 to 8 weeks.\" | Bacitracin Ophthalmic Ointment USP, US prescribing information, INDICATIONS AND USAGE and DOSAGE AND ADMINISTRATION (DailyMed SetID 6ed2f2bd-9d2f-46af-a44c-95a02ca034de) - verbatim, for how to apply it: \"The ointment should be applied directly into the conjunctival sac 1 to 3 times daily. In blepharitis all scales and crusts should be carefully removed and the ointment then spread uniformly over the lid margins.\" and for the indication: \"For the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by Bacitracin susceptible organisms.\"", "rationale": "The one topical antibiotic named for anterior blepharitis that a patient in Egypt can actually buy. Erythromycin, named in the same sentence, has no Egyptian eye product at all.", "cautions": [ "Lid hygiene is the treatment; the ointment is added to it. Warm compresses and cleaning the lid margins twice a day do more than any antibiotic here, and the label itself says to remove all scales and crusts before applying.", "The Egyptian pack also contains neomycin, which is one of the commonest causes of contact allergy on the eyelids. If the lids become redder, itchier or more swollen on treatment, suspect the drops before assuming the blepharitis is worsening, and stop them.", "Ointment blurs vision for a few minutes after application, so at bedtime suits most people.", "No contact lenses while treating.", "Blepharitis is chronic. Expect to control it rather than cure it, and expect it back after the course." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Same application in children: lid margins cleaned first, ointment spread along them 1 to 3 times a day. The label sets no weight-based dose - it is applied to the lid, not swallowed.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "NEOPOLYBACIN EYE OINT. 5 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 5000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": "neomycin, polymyxin" } ], "condition_id": "blepharitis" }, { "id": 309, "generic": "Erythromycin", "line": 1, "is_adjunct": false, "form": "eye", "strength_mg": null, "adult_dose": "Apply 0.5% ophthalmic ointment thin ribbon along lid margins at bedtime for 1-2 weeks combined with daily warm compresses and lid hygiene", "adult_duration": "1-2 weeks", "dose_source": "AAO Blepharitis Preferred Practice Pattern 2018", "rationale": "Topical macrolide antibiotic ointment applied to the lid margins to reduce the bacterial component of blepharitis; supplements lid hygiene and warm compresses, which remain the foundation of treatment rather than being replaced by the antibiotic.", "cautions": [ "Erythromycin is not obtainable in Egypt in this form. Every erythromycin eye product is absent from the national product list entirely, all 16 oral products are marked withdrawn, and the only three live topical products are acne preparations. Prescribe bacitracin instead: the same sentence of the same source names the two as equals, and bacitracin is stocked here.", "Lid hygiene is the treatment; the ointment is added to it. Warm compresses and cleaning the lid margins twice a day do more than any antibiotic here.", "No contact lenses while treating.", "Ointment blurs vision for a few minutes after application." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Apply thin ribbon of 0.5% eye ointment to lid margins at bedtime for 1 week", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "AKNEMYCIN 2% OINT. 15 GM (N/A)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > HERMAL-GERMANY", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": false, "discontinued": true, "also_contains": null }, { "trade_name": "ACNI-CARE 2% TOP. GEL. 20 GM (N/A)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 6.5, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": false, "discontinued": true, "also_contains": null }, { "trade_name": "ERYTHROCID 200 MG/5ML SUSP. 60ML (N/A)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 5.6, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": true, "exact_form": false, "discontinued": true, "also_contains": null }, { "trade_name": "ERYTHROMYCIN PHARCO 200MG/5ML SUSP. 60ML (N/A)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 7.5, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": true, "exact_form": false, "discontinued": true, "also_contains": null }, { "trade_name": "AKNEMYCIN 2% SOLUTION 25 ML (N/A)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > HERMAL-GERMANY", "price_egp": 9.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": false, "discontinued": true, "also_contains": null }, { "trade_name": "ETHYRONATE 200MG/5ML SUSP. 100 ML (N/A)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 9.5, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": true, "exact_form": false, "discontinued": true, "also_contains": null }, { "trade_name": "ETHYRONATE 400MG/5ML SUSP. 100 ML (N/A)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 11.75, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": false, "discontinued": true, "also_contains": null }, { "trade_name": "ACNI-CARE 2% LOTION 25 ML (N/A)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 20.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": false, "discontinued": true, "also_contains": null } ], "condition_id": "blepharitis" }, { "id": 311, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Blepharitis - disease-level clinical article (blepharitis-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Unilateral or atypical blepharitis requires eyelid biopsy to rule out malignancy (basal cell carcinoma or sebaceous carcinoma)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "blepharitis" }, { "id": 310, "generic": "Doxycycline", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 50.0, "adult_dose": "50-100 mg once daily orally for 4-6 weeks for severe posterior blepharitis / meibomian gland dysfunction", "adult_duration": "4-6 weeks", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph)", "rationale": "A tetracycline with anti-inflammatory as well as antibacterial action at the lid margin. The Egyptian National Drug Formulary's doxycycline monograph (Antimicrobial, 2023) sets the paediatric threshold at 8 years, not 12: below that age it is reserved for severe infections that may threaten life, or for cases with no better alternative.", "cautions": [ "CONTRAINDICATED in pregnancy and breastfeeding - use lid hygiene alone, or refer.", "RESTRICTED under 8 years old. The Egyptian National Drug Formulary's doxycycline monograph (Antimicrobial, 2023) reserves use below that age for severe infections that may threaten life, or for cases with no better alternative. The risk is permanent tooth discolouration and enamel hypoplasia while teeth are still forming, and blepharitis is not that kind of infection.", "There is a photosensitivity risk and sun protection is required." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Use under 8 years only for a severe or potentially life-threatening infection, or where no better alternative exists - the risk is permanent tooth discoloration and enamel hypoplasia during tooth development. Where it is justified: 2.2 mg/kg every 12 hours, maximum 100 mg per dose.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DOXYCOST 50MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PENTA PHARMA", "price_egp": 51.0, "pack_count": 30, "unit_price": 1.7, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "blepharitis" } ] }