OBJECTIVE: To determine whether treatment with oral azithromycin compared with topical tetracycline reduces the recurrence of trichiasisfor 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.
RCT Entities:
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: R J Bowman; A Sillah; C Van Dehn; V M Goode; M M Muqit; M Muquit; G J Johnson; P Milligan; J Rowley; H Faal; R L Bailey Journal: Invest Ophthalmol Vis Sci Date: 2000-12 Impact factor: 4.799
Authors: Emily S West; Harran Mkocha; Beatriz Munoz; David Mabey; Allen Foster; Robin Bailey; Sheila K West Journal: Invest Ophthalmol Vis Sci Date: 2005-02 Impact factor: 4.799
Authors: Anthony W Solomon; Matthew J Burton; Emily W Gower; Emma M Harding-Esch; Catherine E Oldenburg; Hugh R Taylor; Lamine Traoré Journal: Nat Rev Dis Primers Date: 2022-05-26 Impact factor: 52.329
Authors: Katherine Pearson; Dereje Habte; Mulat Zerihun; Jonathan D King; Teshome Gebre; Paul M Emerson; Mark H Reacher; Jeremiah M Ngondi Journal: Ethiop J Health Sci Date: 2013-07
Authors: Riju Shrestha; Shannath L Merbs; Belay Bayissasse; Alemayehu Sisay; Colin Beckwith; Paul Courtright; Emily W Gower Journal: Int Health Date: 2022-04-06 Impact factor: 3.131