Single-dose azithromycin prevents trichiasis recurrence following surgery - Randomized trial in Ethiopia
Single-dose azithromycin prevents trichiasis recurrence following surgery - Randomized trial in Ethiopia
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DOI：
10.1001/archopht.124.3.309
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发表时间：
2006-03-01
影响因子：
--
通讯作者：
Quinn, T
中科院分区：
文献类型：
--
作者：
West, SK;West, ES;Quinn, T
背景资料：手术后倒睫复发是一个严重的问题，沙眼programmes.Objective：为了确定如果术后治疗阿奇霉素与局部四环素相比，减少复发长达1年，如果阿奇霉素治疗的家庭成员提供额外的好处相比，只治疗手术patient.Design：一个随机，单盲，临床试验在埃塞俄比亚进行。共有1452例倒睫患者按1：1：1的比例随机分为以下3组：单剂量（1 g）阿奇霉素口服组，家庭成员单剂量阿奇霉素组（20 mg/kg至1 g）加患者，或局部四环素（每天两次，共6周）。主要结果测量：术后1年内倒睫复发。阿奇霉素联合治疗组复发率显著低于局部四环素治疗组，分别为6.9/100人-年和10.3/100人-年（P = 0.047）。与仅治疗外科患者的100人年的5.8人相比，治疗家庭成员的手臂没有额外的减少，为8.1人年（P = .19）.结论：在沙眼流行地区，单剂量阿奇霉素与局部四环素相比，可使术后倒睫复发率降低三分之一。在阿奇霉素是沙眼控制计划的一部分的国家，沙眼倒睫患者应在术后进行治疗，以防止复发。
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 person-years (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 of azithromycin 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.