Preventing Long-Term Ocular Complications of Trachoma With Topical Azithromycin: A 3-Year Follow-up Study.
OBJECTIVE
To determine the role of a single cycle of topical azithromycin in preventing long-term trachoma complications in children from an area with endemic trachoma.


METHODS
A longitudinal cohort study.


METHODS
Two hundred thirty-eight (n = 238) children with active trachoma were enrolled in the current study. They were aged 1 to 10 years, with trachomatous inflammation based on the simplified World Health Organization grading system. These children were identified out of a survey of 8600 children from 7 villages in Punjab, Pakistan, where trachoma was endemic. The studied patients with active trachoma were treated with a single regimen of azithromycin 1.5% eye drops, given twice daily for 3 days, and were followed up for 3 years. The long-term effects of this therapy were documented for the first time in an endemic area.


RESULTS
Two hundred fourteen children (90%) were present at 1-year follow-up with 10% dropout, and 178 (75%) were present at 3-year follow-up with 25% dropout. Of these, 23% and 11% had active trachoma at 1 and 3 years, respectively. Active trachoma was minimized from 100% at baseline to 11% at the end of 3 years. The reinfection rate was 4%. None of the patients developed trachoma-related ocular complications during the study period.


CONCLUSIONS
A single cycle of topical azithromycin can be used as an effective and safe option for treating active trachoma in children in endemic areas. This study also documented that a single cycle of topical azithromycin prevents trachoma-related ocular complications in an endemic area.
Department of Orbit and Oculoplastics, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan.
Tayyab
T
Afghani
Department of Community Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan.
Hassan
H
Mansoor
Department of Community Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan.
Mohammad
M
Nadeem
D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D010154:Pakistan; D012008:Recurrence; D014141:Trachoma / Q000150:complications / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D009883:Ophthalmic Solutions; D017963:Azithromycin
azithromycin; children; eye drops; single; trachoma