title: Efficacy of oral azithromycin versus topical tetracycline in mass treatment of endemic trachoma.
abstract: OBJECTIVE
  To compare the impact of mass treatment with oral azithromycin and topical tetracycline on the prevalence of active trachoma.
  
  
  METHODS
  A total of 1803 inhabitants from 106 households of eight Gambian villages were randomized, in pairs, to receive either three doses of azithromycin at weekly intervals, or daily topical tetracycline over 6 weeks. Ocular examinations were conducted before treatment, and 2, 6 and 12 months after treatment.
  
  
  RESULTS
  Prior to treatment, 16% of the study participants had active trachoma. Two months after treatment, the prevalence of trachoma was 4.6% and 5.1% in the azithromycin and the tetracycline groups, respectively (adjusted odds ratio (OR) = 1.09; 95% confidence interval (CI) = 0.53, 2.02). Subsequently, the prevalence rose to 16% in the tetracycline group, while remaining at 7.7% in the azithromycin group (adjusted OR at 12 months = 0.52; 95% CI = 0.34, 0.80). At 12 months post-treatment, there were fewer new prevalent cases in the azithromycin group, and trachoma resolution was significantly better for this group (adjusted OR = 2.02; 95% CI = 1.42, 3.50).
  
  
  CONCLUSIONS
  Oral azithromycin therefore appears to offer a means for controlling blinding trachoma. It is easy to administer and higher coverages may be possible than have been achieved hitherto.
authors.affiliation: Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine (LSHTM), London, England.
authors.forename: N
authors.initials: N
authors.lastname: Fraser-Hurt
authors.forename: R L
authors.initials: RL
authors.lastname: Bailey
authors.forename: S
authors.initials: S
authors.lastname: Cousens
authors.forename: D
authors.initials: D
authors.lastname: Mabey
authors.forename: H
authors.initials: H
authors.lastname: Faal
authors.forename: D C
authors.initials: DC
authors.lastname: Mabey
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017963:Azithromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004341:Drug Evaluation; D019353:Endemic Diseases / Q000517:prevention & control*; D005260:Female; D005714:Gambia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D013754:Tetracyclines / Q000008:administration & dosage / Q000627:therapeutic use*; D014141:Trachoma / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D013754:Tetracyclines; D017963:Azithromycin