A controlled
chemotherapy trial of
trachoma was carried out in a Tunisian oasis among schoolchildren with active disease. We compared 1%
tetracycline ointment (79 patients) or 1%
rifampicin ointment (76 patients) with 5%
boric acid ointment (79 patients). Medications were administered twice daily, six days a week, for ten weeks.
Slit-lamp examinations by three ophthalmologists were made independently before treatment as well as five, 19, and 39 weeks
after treatment. Bacteriologic cultures were taken during treatment as were smears to detect
trachoma agent at each clinical examination. Five weeks
after treatment, the intensity of
conjunctival disease in the
tetracycline and
rifampicin groups was reduced significantly when compared with
boric acid, but at 19 weeks this suppression was found only in the
tetracycline group. Ocular bacterial pathogens were eliminated almost entirely in the two
antibiotic groups during treatment. The initial prevalence of
trachoma (29to 31%) was significantly reduced in the two
antibiotic-treated groups at five weeks and 19 weeks
after treatment. The prevalence of
trachoma was equally low (7%) in all three groups following
retreatment with
tetracycline. Although both
antibiotics were effective,
rifampicin offered no advantage over
tetracycline in this trial. Recurrent disease in this school-based treatment study probably was due to
reinfection from younger siblings at home. While systematic, community-wide,
antibiotic treatment programs are not always possible in countries where
trachoma is endemic, limited
antibiotic therapy programs should be continued in these areas to reduce the intensity and prevalence of
trachoma, even though the disease cannot be eradicated.