title: Trimethoprim-Sulfamethoxazole Versus Placebo in Reducing the Risk of Toxoplasmic Retinochoroiditis Recurrences: A Three-Year Follow-up.
abstract: OBJECTIVE
  To compare the effects of 1 year of treatment with trimethoprim/sulfamethoxazole (TMP-SMZ) vs a placebo in reducing the risk of toxoplasmic retinochoroiditis recurrences during a 3-year follow-up period.
  
  
  METHODS
  Randomized, double-masked clinical trial.
  
  
  METHODS
  This cohort included 141 volunteers recruited in Campinas, Brazil. Inclusion criterion was unilateral active recurrent toxoplasmic retinochoroiditis. All volunteers were treated with 1 tablet of TMP-SMZ (160 mg/800 mg) twice daily for 45 days, and all lesions healed after this treatment. After this initial treatment, the volunteers were randomly assigned to Group 1 (1 TMP-SMZ tablet every 2 days for 311 days) or Group 2 (1 identical placebo tablet containing starch with no active ingredients every 2 days for 311 days). At the second- and third-year follow-up appointments, none of the volunteers received treatment unless a new recurrence episode had occurred. The primary outcomes were recurrent toxoplasmic retinochoroiditis within the first year of follow-up and recurrent toxoplasmic retinochoroiditis within the third year of follow-up.
  
  
  RESULTS
  The cumulative probability of recurrence at 1, 2, and 3 years of follow-up were, respectively, 13.0% (9/69), 17.4% (12/69), and 20.3% (14/69) in the placebo group and 0% (0/72) in the TMP-SMZ group (P < .001, log-rank test). There was no case of multiple recurrences in the same individual. No treatment-limiting toxicity or side effects were observed in either group. New recurrences were more frequent among female volunteers.
  
  
  CONCLUSIONS
  TMP-SMZ may be used safely for prophylaxis of recurrent toxoplasmic retinochoroiditis, with long-term benefits.
authors: State University of Campinas (UNICAMP), Campinas, Brazil. Electronic address: joaopaulofelix@hotmail.com.
authors: João Paulo
authors: JP
authors: Fernandes Felix
authors: State University of Campinas (UNICAMP), Campinas, Brazil; Federal University of Pernambuco (UFPE), Recife, Brazil.
authors: Rodrigo Pessoa
authors: RP
authors: Cavalcanti Lira
authors: State University of Campinas (UNICAMP), Campinas, Brazil.
authors: Alexandre Brito
authors: AB
authors: Cosimo
authors: State University of Campinas (UNICAMP), Campinas, Brazil.
authors: Rodrigo Lourenço
authors: RL
authors: Cardeal da Costa
authors: State University of Campinas (UNICAMP), Campinas, Brazil.
authors: Mauricio Abujamra
authors: MA
authors: Nascimento
authors: State University of Campinas (UNICAMP), Campinas, Brazil.
authors: Carlos Eduardo
authors: CE
authors: Leite Arieta
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002825:Chorioretinitis / Q000469:parasitology / Q000517:prevention & control*; D004311:Double-Blind Method; D015822:Eye Infections, Parasitic / Q000469:parasitology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011446:Prospective Studies; D012008:Recurrence; D055502:Secondary Prevention; D014126:Toxoplasmosis, Ocular / Q000469:parasitology / Q000517:prevention & control*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D010919:Placebos; D015662:Trimethoprim, Sulfamethoxazole Drug Combination