title: Three-year outcomes of the surgery for trichiasis, antibiotics to prevent recurrence trial.
abstract: OBJECTIVE
  To determine whether treatment with oral azithromycin compared with topical tetracycline reduces the recurrence of trichiasis for up to 3 years following surgery for trichiasis.
  
  
  METHODS
  The Surgery for Trichiasis, Antibiotics to Prevent Recurrence (STAR) trial is a randomized, single-masked, clinical trial conducted in southern Ethiopia, a region where trachoma is hyperendemic. A total of 1452 patients who underwent trichiasis surgery were randomly assigned at a 2:1 ratio to either a single dose of oral azithromycin (1 g) or topical tetracycline (twice per day for 6 weeks) following surgery.
  
  
  METHODS
  Recurrence of trichiasis within 3 years following surgery.
  
  
  RESULTS
  The rate of recurrence was 10% in the azithromycin group and 13% in the tetracycline group. The azithromycin group had a 22% reduction in recurrence of trichiasis 3 years after surgery compared with the tetracycline group (P = .13). Severity of entropion at baseline was the most significant predictor of recurrence of trichiasis at 3 years.
  
  
  CONCLUSIONS
  Trichiasis recurrence rates in the STAR trial remained low for up to 3 years following surgery. The protective effect of a single dose of azithromycin was less than at 1 year and, although not statistically significant, was still suggestive up to 3 years following trichiasis surgery.
  
  
  CONCLUSIONS
  A single dose of azithromycin after surgery remains an integral component of the World Health Organization's strategy for the elimination of trachoma by the year 2020.
authors.affiliation: Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287, USA.
authors.forename: Fasika
authors.initials: F
authors.lastname: Woreta
authors.forename: Beatriz
authors.initials: B
authors.lastname: Munoz
authors.forename: Emily
authors.initials: E
authors.lastname: Gower
authors.forename: Wondu
authors.initials: W
authors.lastname: Alemayehu
authors.forename: Sheila K
authors.initials: SK
authors.lastname: West
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D019353:Endemic Diseases; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D055502:Secondary Prevention; D016037:Single-Blind Method; D013752:Tetracycline / Q000008:administration & dosage*; D016896:Treatment Outcome; D058457:Trichiasis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin; D013752:Tetracycline