title: Trimethoprim-sulfamethoxazole versus placebo to reduce the risk of recurrences of Toxoplasma gondii retinochoroiditis: randomized controlled clinical trial.
abstract: OBJECTIVE
  To compare the effects of trimethoprim-sulfamethoxazole vs placebo in reducing the risk of recurrences of Toxoplasma gondii retinochoroiditis.
  
  
  METHODS
  Single-center, prospective randomized double-masked clinical trial.
  
  
  METHODS
  A total of 95 patients from Campinas, Brazil, with active recurrent Toxoplasma gondii retinochoroiditis were included. The initially active toxoplasmosis lesions were successfully treated in all cases using trimethoprim-sulfamethoxazole (800 mg/160 mg) twice daily for 45 days. Subsequently, 5 patients dropped out of the study. The remaining patients were randomized to Group 1 (trimethoprim/sulfamethoxazole tablet every 2 days) or Group 2 (identical placebo tablet every 2 days). Randomization was 1:1, was stratified by sex, and used block sizes of 4. The primary outcome was recurrent toxoplasmosis retinochoroiditis within 1 year, and the secondary outcome was a 1-year change in best-corrected visual acuity (BCVA) (ETDRS chart).
  
  
  RESULTS
  The incidence of recurrent toxoplasmosis retinochoroiditis within 12 months was 0 of 46 (0%) and 6 of 47 (12.80%) in the trimethoprim-sulfamethoxazole and placebo groups, respectively (P = .026). Visual acuity improvements in the 2 groups were similar. No treatment-limiting toxicity was observed.
  
  
  CONCLUSIONS
  Trimethoprim/sulfamethoxazole therapy resulted in a 100% reduction in the recurrence of Toxoplasma gondii retinochoroiditis over 1 year of treatment.
authors.affiliation: Universidade Estadual de Campinas, Campinas, São Paulo, Brazil. Electronic address: joaopaulofelix@hotmail.com.
authors.forename: João Paulo Fernandes
authors.initials: JP
authors.lastname: Felix
authors.affiliation: Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Rodrigo Pessoa Cavalcanti
authors.initials: RP
authors.lastname: Lira
authors.affiliation: Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Rafael Santos
authors.initials: RS
authors.lastname: Zacchia
authors.affiliation: Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Jaqueline Machado
authors.initials: JM
authors.lastname: Toribio
authors.affiliation: Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Mauricio Abujamra
authors.initials: MA
authors.lastname: Nascimento
authors.affiliation: Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
authors.forename: Carlos Eduardo Leite
authors.initials: CE
authors.lastname: Arieta
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002825:Chorioretinitis / Q000469:parasitology / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D055502:Secondary Prevention; D014122:Toxoplasma / Q000302:isolation & purification; D014126:Toxoplasmosis, Ocular / Q000469:parasitology / Q000517:prevention & control*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination