Three-day course of oral azithromycin vs topical oxytetracycline/polymyxin in treatment of active endemic trachoma.

PURPOSE The aim of this study on endemic trachoma was to carry out a comparison of azithromycin (3-day course, oral dose of 10 mg/kg per day) with conventional treatment (topical oxytetracycline/polymyxin ointment; twice a day for 2 months) in a rural area near Sanliurfa, Turkey. METHODS Ninety-six subjects with active trachoma were randomly assigned conventional or azithromycin treatment. Subjects were examined 1, 2, 3, and 6 months after the start of treatment. Clinical findings were recorded for each eye. Swabs were taken from upper eyelids 3 and 6 months after the start of treatment for direct fluorescein antibody test. RESULTS By six-month follow-up, trachoma had resolved clinically in 43 (89.58%) of the 48 subjects who received azithromycin, compared with 33 (68. 75%) of the 48 who were treated conventionally. Microbiological success rates (direct fluorescein antibody test negativity) were 83. 33% in the azithromycin group and 62.50% in the conventional therapy group. Compliance with both treatments was good. By 6 months, 14.58% of the subjects in azithromycin group and 33.33% of the subjects in the topical treatment group were reinfected. There were significant differences in the efficacy of the treatment effects and the re-emergence of disease between the two treatment groups. Azithromycin was well-tolerated. CONCLUSIONS These results indicate that azithromycin may be an effective alternative for patients with active trachoma. As a systemic treatment, a 3-day course oral dose has important potential for trachoma control.