Three-year outcomes of the surgery for trichiasis, antibiotics to prevent recurrence trial.

Abstract

OBJECTIVE:

To determine whether treatment with oral azithromycin compared with topical tetracycline reduces the recurrence of trichiasis for up to 3 years following surgery for trichiasis.

METHODS:

The Surgery for Trichiasis, Antibiotics to Prevent Recurrence (STAR) trial is a randomized, single-masked, clinical trial conducted in southern Ethiopia, a region where trachoma is hyperendemic. A total of 1452 patients who underwent trichiasis surgery were randomly assigned at a 2:1 ratio to either a single dose of oral azithromycin (1 g) or topical tetracycline (twice per day for 6 weeks) following surgery.

MAIN OUTCOME MEASURES:

Recurrence of trichiasis within 3 years following surgery.

RESULTS:

The rate of recurrence was 10% in the azithromycin group and 13% in the tetracycline group. The azithromycin group had a 22% reduction in recurrence of trichiasis 3 years after surgery compared with the tetracycline group (P = .13). Severity of entropion at baseline was the most significant predictor of recurrence of trichiasis at 3 years.

CONCLUSION:

Trichiasis recurrence rates in the STAR trial remained low for up to 3 years following surgery. The protective effect of a single dose of azithromycin was less than at 1 year and, although not statistically significant, was still suggestive up to 3 years following trichiasis surgery.

APPLICATION TO CLINICAL PRACTICE:

A single dose of azithromycin after surgery remains an integral component of the World Health Organization's strategy for the elimination of trachoma by the year 2020.

• Authors: Fasika Woreta, Beatriz Munoz, Emily Gower, Wondu Alemayehu, Sheila K West
• Journal: Archives of ophthalmology (Chicago, Ill. : 1960) (Arch Ophthalmol) Vol. 130 Issue 4 Pg. 427-31 (Apr 2012) ISSN: 1538-3601 [Electronic] United States
• PMID: 22159169 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)

Chemical References

• Anti-Bacterial Agents
• Azithromycin
• Tetracycline

Topics

• Administration, Oral
• Administration, Topical
• Anti-Bacterial Agents (administration & dosage)
• Azithromycin (administration & dosage)
• Endemic Diseases
• Ethiopia (epidemiology)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Male
• Middle Aged
• Ophthalmologic Surgical Procedures
• Secondary Prevention
• Single-Blind Method
• Tetracycline (administration & dosage)
• Treatment Outcome
• Trichiasis (drug therapy, epidemiology, prevention & control, surgery)