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A Single Dose of One Antibiotic for Treating Trichiasis
is More Effective than a Six-week Regimen of Another
Antibiotic
A clinical trial funded by the National Eye Institute
(NEI), part of the National Institutes of Health (NIH),
has concluded that a single dose of azithromycin taken
by mouth after surgery reduces by one-third the recurrence
of a vision-threatening eyelid condition called trichiasis.
This is in contrast to the usual six-week regimen of
tetracycline ointment applied directly to the eye. This
study is published in the March 2006 issue of Archives
of Ophthalmology.
According to NIH, an estimated 11 million people worldwide
develop trichiasis every yea and so this finding will
definitely have an impact in preventing future vision
loss.
Trichiasis is a condition in which the eyelid turns
inward and eyelashes rub against the eye, resulting
in corneal scarring and loss of vision. It results from
trachoma, an eye infection that is the leading preventable
cause of blindness in the world. It is spread through
contact with flies and other insects, clothing or household
items that harbor the bacterium, or infected people.
Trachoma occurs in poor, overcrowded communities that
have little access to clean water, waste treatment facilities,
or health care. These communities are located mainly
in Africa, the Middle East, Asia, Australia and some
areas of Latin America.
The World Health Organization (WHO) previously endorsed
a multi-faceted strategy to control trachoma, including
surgery for trichiasis and application of tetracycline
after surgery.
In this study, called Surgery for Trichiasis, Antibiotics
to Prevent Recurrence (STAR), eye infection with the
bacterium that causes trachoma was present in 19 percent
of the adults with trichiasis in Wolayta Zone, Ethiopia,
the location of the clinical trial. More than 77 percent
of the patients were women, who have four times the
rate of trichiasis than men. Women often contract trachoma
repeatedly by taking care of infected children.
According to study chairman Sheila K. West, Ph.D.,
Wilmer Eye Institute, Johns Hopkins University the simple
surgical repair of the eyelid to prevent blindness has
been plagued by high rates of recurrence of trichiasis
- up to 50 percent in some areas. By administering a
single dose of azithromycin after eyelid surgery, the
recurrence of trichiasis was reduced by 33 percent.
The high rate of recurrence was mostly due to poor surgical
technique.
Pfizer, Inc., through the International Trachoma Initiative
that it co-sponsors with the Edna McConnell Clark Foundation,
provided the azithromycin used in this trial.
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