Background:Trichiasis recurrence following surgery is a serious problem for trachoma programs.Objective:To determine if postoperative treatment with azithromycin compared with topical tetracycline reduces recurrence u...Background:Trichiasis recurrence following surgery is a serious problem for trachoma programs.Objective:To determine if postoperative treatment with azithromycin compared with topical tetracycline reduces recurrence up to 1 year,and if azithromycin treatment of household members provides additional benefit compared with treating only the surgical patient.Design:A randomized,single-masked,clinical trial was conducted in Ethiopia.A total of 1452 patients with trichiasis were randomized 1:1:1 to the following 3 arms:single-dose(1 g)oral azithromycin alone,single-dose azithromycin for household members(20 mg/kg up to 1 g)plus the patient,or topical tetracycline(twice per day for 6 weeks).Main Outcome Measures:Trichiasis recurrence within 1 year following surgery.Results:The combined azithromycin groups had significantly fewer recurrences,6.9 of 100 person-years overall,compared with topical tetracycline,10.3 of 100 personyears(P=.047).There was no additional reduction in the arm that also treated household members,8.1 of 100 person-years,compared with treating the surgical patients alone,5.8 of 100 person-years(P=.19).Conclusions:In trachoma-endemic areas,a single dose ofazithromycin reduced postoperative trichiasis recurrence rates by one third compared with topical tetracycline.Application to Clinical Practice:In countries where azithromycin is part of the Trachoma Control Program,patients with trachomatous trichiasis should be treated postoperatively to prevent recurrence.展开更多
文摘Background:Trichiasis recurrence following surgery is a serious problem for trachoma programs.Objective:To determine if postoperative treatment with azithromycin compared with topical tetracycline reduces recurrence up to 1 year,and if azithromycin treatment of household members provides additional benefit compared with treating only the surgical patient.Design:A randomized,single-masked,clinical trial was conducted in Ethiopia.A total of 1452 patients with trichiasis were randomized 1:1:1 to the following 3 arms:single-dose(1 g)oral azithromycin alone,single-dose azithromycin for household members(20 mg/kg up to 1 g)plus the patient,or topical tetracycline(twice per day for 6 weeks).Main Outcome Measures:Trichiasis recurrence within 1 year following surgery.Results:The combined azithromycin groups had significantly fewer recurrences,6.9 of 100 person-years overall,compared with topical tetracycline,10.3 of 100 personyears(P=.047).There was no additional reduction in the arm that also treated household members,8.1 of 100 person-years,compared with treating the surgical patients alone,5.8 of 100 person-years(P=.19).Conclusions:In trachoma-endemic areas,a single dose ofazithromycin reduced postoperative trichiasis recurrence rates by one third compared with topical tetracycline.Application to Clinical Practice:In countries where azithromycin is part of the Trachoma Control Program,patients with trachomatous trichiasis should be treated postoperatively to prevent recurrence.
