Dawson C R, Daghfous T, Whitcher J, Messadi M, Hoshiwara T, Triki F, Chadgrah F, Briones O, Yoneda C, Schachter J
Bull World Health Organ. 1981;59(1):91-7.
In communities with endemic blinding trachoma, mass (or "blanket") treatment with a topically applied tetracycline derivative is a standard control measure. The widely used "intermittent" treatment schedule consists of the twice daily application of antibiotic ointment for five consecutive days once a month for six months. In this study, the efficacy of "intermittent" treatment was evaluated for the treatment of severe and moderate intensity trachoma in children in southern Tunisia. Tetracycline or erythromycin ointments (specific antichlamydial drugs) were compared with 5% boric acid ointment (a simple antiseptic) given by the intermittent schedule during the winter and spring. There was a statistically significant degree of improvement at only one examination, four weeks after the full course of treatment had been completed. When re-examined five months later there were no differences in intensity in the three groups. The limited effect of topical chemotherapy might be attributable to several causes, among which could be inadequate drug levels, inadequate treatment periods, reinfection from non-treated children in the community, and auto-infection from extraocular sites (e.g., respiratory tract) in the same child. The possible value of short-term (two weeks) systemic antimicrobial therapy as an additional strategy to prevent blindness of children with potentially blinding active trachoma is discussed.
在地方性致盲性沙眼流行的社区，局部应用四环素衍生物进行群体（或“全面”）治疗是一项标准的控制措施。广泛使用的“间歇性”治疗方案包括每月一次，连续五天每天两次涂抹抗生素眼膏，持续六个月。在本研究中，对突尼斯南部儿童中重度沙眼的“间歇性”治疗效果进行了评估。在冬季和春季，将四环素或红霉素眼膏（特异性抗衣原体药物）与按照间歇性方案给予的5%硼酸眼膏（一种简单的防腐剂）进行比较。在完成整个疗程四周后的仅一次检查中，有统计学显著程度的改善。五个月后重新检查时，三组的沙眼严重程度没有差异。局部化疗效果有限可能有多种原因，其中包括药物水平不足、治疗期不足、社区中未治疗儿童的再感染以及同一儿童眼外部位（如呼吸道）的自身感染。本文讨论了短期（两周）全身抗菌治疗作为预防有潜在致盲性活动性沙眼儿童失明的附加策略的可能价值。
