A Comparison of Oral Azithromycin with Topical Oxytetracycline/Polymyxin for the Treatment of Trachoma in Children

• Published in: Clinical infectious diseases 1997-03, Vol.24 (3), p.363-368
• Main Authors: Dawson, C. R., Schachter, J., Sallam, S., Sheta, A., Rubinstein, R. A., Washton, H.
• Format: Article
• Language: English
• Subjects: Administration, Oral; Administration, Topical; Anti-Bacterial Agents - administration & dosage; Azithromycin - administration & dosage; Bacterial diseases; Bacterial diseases of the eye and orbit; Biological and medical sciences; Blindness; Child; Child, Preschool; Children; Chlamydia trachomatis; Chlamydia trachomatis - isolation & purification; Clinical Articles; Conjunctiva - microbiology; Dosage; Drug Therapy, Combination - administration & dosage; Egypt; Epidemics; Epidemiology; Eyes; Female; Human bacterial diseases; Humans; Infections; Infectious diseases; Male; Medical sciences; Ointments; Ophthalmic Solutions; Oxytetracycline - administration & dosage; Pilot Projects; Placebos; Polymyxins - administration & dosage; Trachoma; Trachoma - drug therapy
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1093/clinids/24.3.363

Trachoma, an infectious keratoconjunctivitis caused by Chlamydia trachomatis, is a leading cause of preventable blindness in developing countries. In this study we compared oral azithromycin with oxytetracycline/polymyxin eye ointment (once daily for 5 days every 4 weeks; total of six treatment cycles) for the treatment of active endemic trachoma in 168 rural Egyptian children. A suspension of azithromycin was administered to children as a dose of 20 mg/kg by one of three schedules: a single dose, one dose a week for 3 weeks, and one dose every 4 weeks for a total of six doses. The children's clinical status and chlamydial infection rates were evaluated for 1 year. The clinical cure rates were 35% 2 months after initial treatment, 16% at 8 months (during the annual autumn epidemic of purulent conjunctivitis), and 47% at 1 year. The pretreatment chlamydial infection rate of 33% (determined by direct immunofluorescence) decreased to 5% at 2 months and was 9% at 12 months. There were no significant clinical or laboratory differences among the four treatment groups. Thus, 1–6 doses of azithromycin were equivalent to 30 days of topical oxytetracycline/ polymyxin ointment and may offer an effective alternative means of controlling endemic trachoma.