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Open Access 01-12-2022 | Doxycycline | Study protocol

Ocular Rosacea microBiome Study (ORBS)—sub-microbial versus antibiotic dosing of doxycycline versus placebo in treatment of symptomatic ocular rosacea: study protocol for a parallel-arm randomized clinical trial

Authors: Hamidah Mahmud, Jeremy D. Keenan, John Gonzales, Julie Schallhorn, Matilda Chan, Benjamin Arnold, Victoria Cavallino, Thomas M. Lietman, Thuy Doan, Gerami D. Seitzman

Published in: Trials | Issue 1/2022

Abstract

Background

Ocular rosacea is common and is often managed with long-term antibiotic treatment. Doxycycline is the most commonly selected antibiotic for the treatment of rosacea. As there is no established standard of care treatment dose for rosacea, prescribed doses of doxycycline vary widely. The FDA classifies 40 mg daily dose of doxycycline for ocular rosacea as sub-microbial in comparison to an antibiotic dose of 200 mg daily. However, this “sub-microbial” dose has never been evaluated in patients with ocular rosacea, and even the sub-microbial dose has potential to alter systemic mucosa flora. Here, we present a randomized controlled trial using RNA sequencing to fully characterize the impact of sub-microbial antibiotic dosing of doxycycline on antimicrobial resistance and bacterial composition of the ocular and gut flora.

Methods

In a triple-masked parallel randomized control trial, patients with ocular rosacea will be randomized to three arms: a 40-mg dose of doxycycline, a 200-mg antibiotic dose of doxycycline, or placebo. Collected rectal and lower eyelid samples will be compared for frequency of antimicrobial resistance genetic determinants and microbiome diversity. A subjective ocular surface disease index survey and objective tear breakup time measurement will be determined.

Discussion

These results will enhance our understanding of the overall systemic impact of long-term systemic sub-microbial antibiotic dosing for the treatment of chronic recurrent ocular inflammatory diseases.

Trial registration

This trial was registered on ClinicalTrials.org (NCT05296837) on March 22, 2022.

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Title: Ocular Rosacea microBiome Study (ORBS)—sub-microbial versus antibiotic dosing of doxycycline versus placebo in treatment of symptomatic ocular rosacea: study protocol for a parallel-arm randomized clinical trial
Authors: Hamidah Mahmud
Jeremy D. Keenan
John Gonzales
Julie Schallhorn
Matilda Chan
Benjamin Arnold
Victoria Cavallino
Thomas M. Lietman
Thuy Doan
Gerami D. Seitzman
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Doxycycline
Antibiotic
Rosacea
Published in: Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI: https://doi.org/10.1186/s13063-022-06948-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ocular Rosacea microBiome Study (ORBS)—sub-microbial versus antibiotic dosing of doxycycline versus placebo in treatment of symptomatic ocular rosacea: study protocol for a parallel-arm randomized clinical trial

Abstract

Background

Methods

Discussion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

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