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    Default Practical trachoma

    By Prof Dr.Gehad Elnahri
    Practical trachoma

    Trachoma is a bacterial disease caused by Chlamydia trachomatis an obligate intracellular organism

    Treatment of trachoma infection has little controversy

    -oral azithromycin (expensive) +\- topical azithromycin (not available in Egypt, why?)
    Adults 1gm single dose or 500/12hrs for 3 days
    Children 20mg/kg single dose
    -oral tetracyclines cheaper but not suitable for children below 7 (important), tetracycline ointment

    clean water and washing face decreases incidence and severity of infections

    Whom to suspect for trachoma
    1)most common children in rural areas with subacute or chronic follicular conjunctivitis
    2)Egyptians living abroad for a sometime and foreigners are commonly affected; MPCs not quickly responding should be suspected
    3)post operative middle-aged patients from rural areas with irritated eyes after prolonged topical steroids
    4)any Egyptian in a rural area between 18-60 years with chronic or recurrent conjunctivitis

    How to clinically diagnose trachoma?
    Best is looking for
    1)conjunctival follicles at the edge of the everted tarsus
    2)superior corneal infiltrate/stain/vascularization
    Lab work to diagnose trachoma is a research subject until cheap screening tests are available
    Generally when trachoma is suspected it is wiser to treat with a single dose of azithromycin
    Practical trachoma attachment.php?attachmentid=3236&d=1501264222
    By Dr.Alaa Fathi Azithromycin eye drops available as CYANARO 1%(fouda pharmacy), it is used as the systemic therapy I.e.one drop twice 1St day then once daily for 3days
    By Dr.Hassan Sorour Azithromycine for Trachoma
    Dose= 1g (2caps 500mg) ONCE NOT for 3days
    (Empty stomach)

    Ref:WHO

    Pediatric dose
    20mg/kg ONCE
    Ref:WHO

    Eyedrops (cyanaro) dose & duration effecacy
    No reference available!!

    However
    Tetracycline eye ointment
    Twice daily for 6 weeks
    Ref:WHO
    By Dr.
    Gehad Elnahri I prefer the 3 day course; one day course is not always efficient, these guidelines are a bit of a preventive medicine pattern, giving a single dose decreased the overall prevalence of trachoma, is more practical in the community but is not evidence-based on individual cases
    By Dr.Hassan Sorour I agree that we may want to repeat dose in severe cases
    But dose is 20mg/kg up to 1000mg SINGLE dose is recommended by WHO for ERADICATING trachoma not only as preventive measure
    May be dose changes in future by EBM











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