title: Azithromycin versus Sulfadiazine and Pyrimethamine for non-vision-threatening toxoplasmic retinochoroiditis: a pilot study.
abstract: BACKGROUND
  The purpose of this pilot study is to compare the efficacy and tolerance of azithromycin alone as opposed to standard treatment with sulfadiazine and pyrimethamine for active, non-vision-threatening toxoplasmic retinochoroiditis.
  
  
  METHODS
  We conducted a prospective, randomized, institutional clinical study comparing azithromycin to sulfadiazine and pyrimethamine for active, non-vision-threatening toxoplasmic retinochoroiditis. Nineteen out of 75 patients fulfilled inclusion criteria and were randomized into 2 treatment regimens. Nine patients were treated with sulfadiazine and pyrimethamine and 10 patients with azithromycin at a dose of 500 mg qd. Main outcome measures assessed were time to sharpening of lesion borders, time to lesion scarring, time to disease inactivity, and treatment tolerance.
  
  
  RESULTS
  Azithromycin monotherapy achieved lesion scarring and disease inactivity in all but 1 patient. Although no statistically significant difference was found between the 2 patient groups as regards main outcome measures for treatment efficacy, all median times to endpoints (days) were longer for the azithromycin group - time to sharpening of lesion borders on clinical evaluation (25.5 vs. 24) and masked evaluation of photographs (30.5 vs. 24), time to lesion scarring on clinical evaluation (73 vs. 47) and masked evaluation of photographs (71.5 vs. 36) and time to disease inactivity (73 vs. 49). Treatment tolerance was significantly better for the azithromycin group (p=0.0005).
  
  
  CONCLUSIONS
  Azithromycin monotherapy at a dose of 500 mg per day was shown to be effective and well-tolerated for the treatment of active, non-vision-threatening toxoplasmic retinochoroiditis. Duration of treatment was clinically longer for the azithromycin group.
authors.affiliation: Jules-Gonin Eye Hospital, University of Lausanne, Switzerland.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Balaskas
authors.forename: Jean
authors.initials: J
authors.lastname: Vaudaux
authors.forename: Noémie
authors.initials: N
authors.lastname: Boillat-Blanco
authors.forename: Yan
authors.initials: Y
authors.lastname: Guex-Crosier
mesh_terms: D000328:Adult; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D002825:Chorioretinitis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011739:Pyrimethamine / Q000627:therapeutic use*; D013411:Sulfadiazine / Q000627:therapeutic use*; D014126:Toxoplasmosis, Ocular / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000981:Antiprotozoal Agents; D013411:Sulfadiazine; D017963:Azithromycin; D011739:Pyrimethamine