A study being published Online First by the Archives of Ophthalmology, one of the JAMA/Archives journals reveals that, 10% of patients who received a single dose of oral azithromycin (antibiotic) after surgery for trichiasis (a significant worldwide eye problem) experience trichiasis again compared to 13% of patients who received topical tetracycline therapy, with the protective effects apparent for up to 3 years after surgery, although not considerably different between the two medications.

Trachoma is caused by infection with the Chlamydia trachomatis bacteria in the eye and accounts for an estimated 15.5% of blindness in the world. If left untreated Trachoma can lead to chronic follicular conjunctivitis (“pink-eye”), which may cause scarring of the eyelid and turned-in eyelashes rubbing against the surface of the eye. The condition is known as trachomatous trichiasis and can cause scarring of the corneal which can eventually lead to blindness.

The trial – Surgery for Trichiasis, Antibiotics to Prevent Recurrence (STAR) – is a randomized, single-masked, clinical trial carried out in southern Ethiopia, where trachoma is hyperendemic. Fasika Woreta, M.D., M.P.H., of Johns Hopkins University, Baltimore, and colleagues decided to find out if treating patients with oral azithromycin compared with topical tetracycline would reduce the recurrence rate of the condition for up to 3 years after surgery. The team enrolled 1,452 individuals to participate in the study. The participants underwent surgery for trichiasis and were randomly assigned to two groups. One group received a single dose of oral azithromycin (1 gram), while the other group received topical tetracycline (2 times per day for 6 weeks) after surgery.

The researchers explain: “The rate of recurrence was 10 percent in the azithromycin group and 13 percent in the tetracycline group. The azithromycin group had a 22 percent reduction in recurrence of trichiasis three years after surgery compared with the tetracycline group,” even though this different was not statistically considerable.

They continue:

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

The researchers conclude:

“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.”

Written by Grace Rattue