A randomised controlled trial of azithromycin following surgery for trachomatous trichiasis in the Gambia
A randomised controlled trial of azithromycin following surgery for trachomatous trichiasis in the Gambia
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DOI：
10.1136/bjo.2004.062489
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发表时间：
2005-10-01
影响因子：
4.1
通讯作者：
Bailey, RL
中科院分区：
文献类型：
--
作者：
Burton, MJ;Kinteh, F;Bailey, RL
背景/目的：沙眼性倒睫在手术后经常复发。几个因素可能促进复发：术前疾病严重程度，外科医生的能力，外科手术，愈合反应和感染。本研究探讨是否加强控制感染，沙眼衣原体和其他细菌，阿奇霉素可以提高手术结果在沙眼controllingprogramme.Methods：个人沙眼倒睫进行了检查和操作。手术后，患者被随机分配到阿奇霉素组或对照组。阿奇霉素组及其家庭中的儿童给予阿奇霉素剂量。在6个月时重复抗生素治疗。所有患者在6个月和12个月时进行重新评估。在每次检查时收集样本进行沙眼衣原体聚合酶链反应和一般微生物学检查。426例（94%）在1年时重新评估，其中176例（41.3%）有一根或多根睫毛接触眼睛，84例（19.7%）有五根或更多睫毛。阿奇霉素组倒睫复发率与对照组无差异。复发性倒睫与12个月时更严重的术前倒睫、细菌感染和严重结膜炎症显著相关。外科医生之间的结果存在显著差异。视力和症状显着改善后surgery.Conclusion：在这种情况下，活动性沙眼的患病率较低，阿奇霉素并没有改善沙眼控制计划进行倒睫手术的结果。倒睫手术审核应常规进行。
Background/aim: Trachomatous trichiasis frequently returns following surgery. Several factors may promote recurrence: preoperative disease severity, surgeon ability, surgical procedure, healing responses, and infection. This study investigates whether enhanced control of infection, both of Chlamydia trachomatis and other bacteria, with azithromycin can improve surgical outcome in a trachoma control programme.Methods: Individuals with trachomatous trichiasis were examined and operated. After surgery patients were randomised to the azithromycin or control group. The azithromycin group and children in their household were given a dose of azithromycin. Antibiotic treatment was repeated at 6 months. All patients were reassessed at 6 months and 12 months. Samples were collected for C trachomatis polymerase chain reaction and general microbiology at each examination.Results: 451 patients were enrolled. 426 (94%) were reassessed at 1 year, of whom 176 (41.3%) had one or more lashes touching the eye and 84 (19.7%) had five or more lashes. There was no difference in trichiasis recurrence between the azithromycin and control group. Recurrent trichiasis was significantly associated with more severe preoperative trichiasis, bacterial infection, and severe conjunctival inflammation at 12 months. Significant variability in outcome was found between surgeons. Visual acuity and symptoms significantly improved following surgery.Conclusion: In this setting, with a low prevalence of active trachoma, azithromycin did not improve the outcome of trichiasis surgery conducted by a trachoma control programme. Audit of trichiasis surgery should be routine.