Basilion Eva V, Kilima Peter M, Mecaskey Jeffrey W
International Trachoma Initiative, 441 Lexington Avenue, Suite 1101, New York, NY 10017-3910, USA.
Trans R Soc Trop Med Hyg. 2005 Jan;99(1):6-12. doi: 10.1016/j.trstmh.2004.01.014.
Recent data showing that azithromycin is safe at higher dosages than previously documented provide an opportunity to explore several important improvements in the efficiency and effectiveness of height-based treatment of paediatric trachoma. The purpose of this study is to examine the feasibility of a single standardised schedule for application in any trachoma-endemic region. Data for 60813 children from Asia, North and sub-Saharan Africa were analysed. A height schedule maximizing the number of children receiving treatment of 20-40 mg/kg, a conservative estimate of the safe and effective treatment range for paediatric trachoma, was developed. Using the standardised schedule, 97.7% of children aged 6 to 59 months receiving oral suspension and 96.7% of children aged 60 months to 15 years receiving tablets would have received treatment within a dosage range of 20-40 mg/kg. Less than 1% of all children would have received treatment less than 20 mg/kg. These findings suggest that the schedule presented in this paper is likely to yield safe and effective treatment for a broad range of populations vulnerable to trachoma while substantially improving the efficiency of height-based treatment.
近期数据显示，阿奇霉素在高于先前记录的剂量下是安全的，这为探索基于身高的儿童沙眼治疗在效率和效果方面的若干重要改进提供了契机。本研究的目的是检验单一标准化方案在任何沙眼流行地区应用的可行性。对来自亚洲、北非和撒哈拉以南非洲的60813名儿童的数据进行了分析。制定了一个身高方案，该方案能使接受20 - 40毫克/千克治疗的儿童数量最大化，这是对儿童沙眼安全有效治疗范围的保守估计。使用该标准化方案，6至59个月接受口服混悬液治疗的儿童中有97.7%以及60个月至15岁接受片剂治疗的儿童中有96.7%将在20 - 40毫克/千克的剂量范围内接受治疗。所有儿童中不到1%的儿童接受的治疗剂量低于20毫克/千克。这些发现表明，本文提出的方案可能为广泛易患沙眼的人群带来安全有效的治疗，同时大幅提高基于身高的治疗效率。
