A comparison of oral azithromycin with topical oxytetracycline/polymyxin for the treatment of trachoma in children.
Trachoma, an infectious keratoconjunctivitis caused by Chlamydia trachomatis, is a leading cause of preventable blindness in developing countries. In this study we compared oral azithromycin with oxytetracycline/polymyxin eye ointment (once daily for 5 days every 4 weeks; total of six treatment cycles) for the treatment of active endemic trachoma in 168 rural Egyptian children. A suspension of azithromycin was administered to children as a dose of 20 mg/kg by one of three schedules: a single dose, one dose a week for 3 weeks, and one dose every 4 weeks for a total of six doses. The children's clinical status and chlamydial infection rates were evaluated for 1 year. The clinical cure rates were 35% 2 months after initial treatment, 16% at 8 months (during the annual autumn epidemic of purulent conjunctivitis), and 47% at 1 year. The pretreatment chlamydial infection rate of 33% (determined by direct immunofluorescence) decreased to 5% at 2 months and was 9% at 12 months. There were no significant clinical or laboratory differences among the four treatment groups. Thus, 1-6 doses of azithromycin were equivalent to 30 days of topical oxytetracycline/polymyxin ointment and may offer an effective alternative means of controlling endemic trachoma.
Dawson
C R
CR
Francis I. Proctor Foundation for Research in Ophthalmology, University of California at San Francisco, 94143-0412, USA.
Schachter
J
J
Sallam
S
S
Sheta
A
A
Rubinstein
R A
RA
Washton
H
H
D000284:Administration, Oral; D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003228:Conjunctiva / Q000382:microbiology; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D004534:Egypt; D005260:Female; D006801:Humans; D008297:Male; D009883:Ophthalmic Solutions; D010118:Oxytetracycline / Q000008:administration & dosage*; D010865:Pilot Projects; D011113:Polymyxins / Q000008:administration & dosage*; D014141:Trachoma / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D009883:Ophthalmic Solutions; D011113:Polymyxins; D017963:Azithromycin; D010118:Oxytetracycline