Journal Article

Adverse and Beneficial Secondary Effects of Mass Treatment with Azithromycin to Eliminate Blindness Due to Trachoma in Nepal

A. M Fry, H. C Jha, T. M Lietman, J. S. P Chaudhary, R. C Bhatta, J Elliott, T Hyde, A Schuchat, B Gaynor and S. F Dowell

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 4, pages 395-402
Published in print August 2002 | ISSN: 1058-4838
Published online August 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/341414
Adverse and Beneficial Secondary Effects of Mass Treatment with Azithromycin to Eliminate Blindness Due to Trachoma in Nepal

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Mass administration of azithromycin to eliminate blindness due to trachoma has raised concerns regarding the emergence of antimicrobial resistance. During 2000, we compared the antimicrobial resistance of nasopharyngeal pneumococcal isolates recovered from and the prevalence of impetigo, respiratory symptoms, and diarrhea among 458 children in Nepal before and after mass administration of azithromycin. No azithromycin-resistant pneumococci were isolated except from 4.3% of children who had received azithromycin during 2 previous mass treatments (P <.001). There were decreases in the prevalence of impetigo (from 14% to 6% of subjects; adjusted odds ratio [OR], 0.41; 95% confidence interval [CI], 0.21–0.80) and diarrhea (from 32% to 11%; adjusted OR, 0.26; 95% CI, 0.14–0.43) 10 days after azithromycin treatment. The absence of macrolide-resistant isolates after 1 mass treatment with azithromycin is encouraging, although the recovery of azithromycin-resistant isolates after 2 mass treatments suggests the need for resistance monitoring when multiple rounds of antimicrobial treatment are given

Journal Article.  4707 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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