Preventing Long-Term Ocular Complications of Trachoma With Topical Azithromycin: A 3-Year Follow-up Study

ObjectiveTo evaluate the effectiveness and safety of azithromycin 1.5% eye drops under field conditions to reduce active trachoma in a highly endemic district in Cameroon. This is a follow-up of an initial report published in 2010.Methods and analysisThree annual campaigns were performed in 2008, 2009 and 2010 to treat the population (~1 20 000 individuals) of the Kolofata Health District with topical azithromycin 1.5% (one drop in each eye, morning and evening for three consecutive days). The effectiveness of this intervention against active trachoma was assessed in children aged 1–9 years in cross-sectional studies prior to each mass treatment using a systematic sampling procedure (in 2008, 2009 and 2010) and then 1 year (2011) and 3 years (2013) after the last intervention among the villages with previously high active trachoma prevalence or never tested.ResultsThe prevalence of trachomatous inflammation—follicular (TF) dropped from 24.0% (95% CI 20.7 to 27.5) before treatment to 2.8% (95% CI 2.2 to 3.7) 1 year after completion of the 3 year campaign. Trachomatous inflammation—intense was present in only 4 (0.2%) children 1 year after the third round of treatment. Three years after the last campaign, the surveillance survey among the most prevalent villages and villages never tested before showed a prevalence of 5.2% (95% CI 3.6 to 7.2) of active trachoma. Tolerance was excellent, with no report of treatment interruption, serious ocular or systemic adverse events.ConclusionAnnual mass treatment with azithromycin eye drops was shown to be effective in reducing TF to a level ≤5% one year after a 3-round annual mass treatment in an endemic region at the district level.

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An eye for azithromycin: review of the literature

Kagkelaris

Makri

Georgakopoulos

et al. 2018

Ophthalmol Eye Dis

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Azithromycin is used widely in clinical practice and recently it is available in topical solution for ophthalmic use. The purpose of the current publication is to summarize the newest information on azithromycin’s clinical usefulness over ocular diseases. A PubMed (National Library of Medicine) and a ScienceDirect search was conducted using the key phrases ‘azithromycin’, ‘meibomian’, ‘blepharitis’, ‘trachoma’, ‘toxoplasmosis’ from 2010 to 2017. Articles were limited to articles published in English or at least having an English abstract. There were no restrictions on age, ethnicity, or geographic locations of patients. Topical azithromycin was found effective and safe in various ocular surface infections, in meibomian gland dysfunction and in trachoma. Also, it may substitute fluoroquinolones in corneal UV cross-linking. The World Health Organization targets for trachoma elimination are being reached only after 3 years of annual mass drug administration. Oral azithromycin can participate in combination regiments for toxoplasmosis, mainly because of its very good safety profile and may play a significant role in toxoplasmosis in pregnancy. Azithromycin is one of the safest antibiotics, well tolerated, and with special pharmacokinetic properties. Also, it is characterized by a broad antimicrobial spectrum. Azithromycin is efficacious for the treatment of a lot of ocular diseases and may be included as monotherapy or in combination therapy in new treatment protocols for more ocular infections. However, more research is needed to determine this.

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Preventing Long-Term Ocular Complications of Trachoma With Topical Azithromycin: A 3-Year Follow-up Study

Abstract: A single cycle of topical azithromycin can be used as an effective and safe option for treating active trachoma in children in endemic areas. This study also documented that a single cycle of topical azithromycin prevents trachoma-related ocular complications in an endemic area.

Cited by 4 publications

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Effectiveness and safety of azithromycin 1.5% eye drops for mass treatment of active trachoma in a highly endemic district in Cameroon

An eye for azithromycin: review of the literature

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