tetracycline and Conjunctivitis--Inclusion

Antibiotics are one of four arms of the SAFE strategy for the control of trachoma, an eye infection that is responsible for more cases of blindness than any condition other than cataract. The evidence for the use of topical tetracycline and oral tetracycline, doxycycline, erythromycin, cotrimoxazole and azithromycin in trachoma are reviewed here and a number of issues are nominated as research and policy priorities.

Topics: Administration, Topical; Animals; Anti-Bacterial Agents; Chlamydia Infections; Chlamydia trachomatis; Conjunctivitis, Inclusion; Doxycycline; Drug Therapy, Combination; Erythromycin; Humans; Ophthalmic Solutions; Randomized Controlled Trials as Topic; Tetracycline; Trachoma; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Animals; Anti-Bacterial Agents; Bacitracin; Bird Diseases; Birds; Chlamydia; Chlamydia Infections; Chloramphenicol; Conjunctivitis, Inclusion; Cycloserine; Disease Models, Animal; Erythromycin; Glycosides; Humans; Lymphogranuloma Venereum; Nystatin; Penicillins; Polymyxins; Psittacosis; Sulfonamides; Tetracycline; Trachoma; Vancomycin

Topics: Animals; Anti-Bacterial Agents; Anti-Infective Agents; Chlamydia Infections; Conjunctivitis, Inclusion; Disease Models, Animal; Humans; Penicillins; Psittacosis; Sulfonamides; Tetracycline; Trachoma

Topics: Adult; Animals; Black or African American; Chick Embryo; Chlamydia; Clinical Trials as Topic; Complement Fixation Tests; Conjunctivitis; Conjunctivitis, Inclusion; Ethnology; Eye Diseases; Fluorescent Antibody Technique; Histological Techniques; Humans; In Vitro Techniques; Inclusion Bodies, Viral; Infant, Newborn; Infant, Newborn, Diseases; Male; Middle Aged; Sulfisoxazole; Tetracycline; Trachoma; Virus Cultivation; White People

The World Health Organization recommends mass treatment of trachoma-hyperendemic communities, but there are scant empiric data on the number of rounds of treatment that are necessary for sustainable reductions. The rates of active trachoma and infection with C. trachomatis were determined in a community 3.5 years after two rounds of mass treatment with azithromycin.. Maindi village in Tanzania received a first round of mass treatment with azithromycin after a baseline survey for trachoma and infection. All residents aged 6 months and older were offered single-dose treatment with azithromycin (excluding pregnant women with no clinical trachoma, who were offered topical tetracycline). The residents were followed over an 18-month period, and, according to similar treatment criteria, were offered retreatment at 18 months. Five years after baseline (3.5 years after the second round of mass treatment), a new census and survey of current residents for trachoma and infection was conducted. Children are the sentinel markers of infection and trachoma in communities, so data are presented specifically for ages 0 to 7 years (preschool age) and 8 to 16 years.. Treatment coverage was above 80% for all ages in the first round, and highest (90%) in preschool-aged children. Second-round coverage was lower, <70%, and 70% in preschool-aged children. At 5 years, trachoma rates were still lower than baseline, ranging from 45% in those aged 0 to 3 years to 8% in those aged 11 to 15 years (compared with 81% and 39% at baseline, respectively). Infection rates at baseline ranged from 71% to 57%, but were 27% to 17% at 5 years after two rounds of mass treatment. At 5 years, there were no differences in trachoma or infection rates, when comparing new residents who came after the second mass treatment with those who had been resident in the village during both rounds (P > 0.05). Infection rates were lower in those who had been treated twice or at 18 months than in those treated only at baseline or never treated.. Although mass treatment appears to be associated with lower disease and infection rates in the long term, trachoma and C. trachomatis infection were not eliminated in this trachoma hyperendemic village 3.5 years after two rounds of mass treatment. Continued implementation of the SAFE strategy in this environment is needed.

Topics: Administration, Oral; Administration, Topical; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Child; Child, Preschool; Chlamydia trachomatis; Conjunctivitis, Inclusion; Endemic Diseases; Female; Humans; Infant; Male; Ophthalmic Solutions; Retreatment; Rural Population; Tanzania; Tetracycline; Trachoma

Sixty two patients diagnosed as having adult chlamydial ophthalmia were treated with oral doxycycline and roxithromycin in association and tetracycline eye wash for 2 weeks. Chlamydial ophthalmia was diagnosed by laboratory detection of the micro-organism in ocular specimens using direct immunofluorescent monoclonal antibody staining for Chlamydia trachomatis, chlamydial culture in cycloheximide treated McCoy cells, and Giemsa staining. An immunoenzymatic method for detection of specific IgG and IgA in patients' serum was used as an additional test to confirm the diagnosis. All patients were reexamined 3 weeks after completing their course of antibiotics and in the case of persistent infection a further course of treatment was given. With this treatment regimen 48 out of 62 patients (77.4%) were cured after three courses. Because of the risks of an inadequate response to therapy, we recommend a proper post-treatment follow up in all patients with chlamydial eye infections.

Topics: Administration, Oral; Adolescent; Adult; Aged; Conjunctivitis, Inclusion; Doxycycline; Drug Therapy, Combination; Female; Fluorescent Antibody Technique; Follow-Up Studies; Humans; Immunoenzyme Techniques; Keratoconjunctivitis; Male; Middle Aged; Ophthalmic Solutions; Roxithromycin; Tetracycline; Treatment Outcome

A study was performed on 321 patients with paratrachoma: acute follicular conjunctivitis-189, subacute-132. The first group of patients (108) received 1% Tetracycline ointment 4 to 5 times daily, the second group (103 patients)-1% Tetracycline ointment + 0.1% Dexamethasone eye drops, the third group (110 patients)-Eubetal ointment (tetracycline 0.5%, betamethasone 0.1%, chloramphenicol 1%, colistin). Therapeutic efficacy was higher in groups were antibiotics combined with corticosteroids. Cured in 4 weeks in group I-46.3%, in group II-72.8%, in group III-71.8%, cured in 6 weeks-75.9%, 88.3% and 86.4% respectively.

Topics: Acute Disease; Administration, Topical; Adolescent; Adult; Betamethasone; Chlamydia Infections; Chloramphenicol; Colistin; Conjunctivitis, Inclusion; Dexamethasone; Drug Combinations; Drug Therapy, Combination; Female; Humans; Male; Ointments; Ophthalmic Solutions; Tetracycline; Treatment Outcome; Urethritis; Uterine Cervicitis

We report three patients with recurrent Chlamydia-associated conjunctivitis. The clinical course of the Chlamydial infection was documented by positive conjunctival smears (direct immunofluorescence staining) and the evaluation of the IgA-titer in the sera (immunoperoxidase assay). The recovery of the ocular symptoms after therapy onset correlated well with the negative results of the conjunctival smears and the decrease in IgA level in the sera. The recurrence of the conjunctivitis was accompanied by an increase in the IgA titer in the sera of all three patients and the presence of Chlamydial elementary bodies in the conjunctival scrapings in two cases. Three patients showed immunologic pecularities: two had an allergic diathesis; the third patient developed Wegener disease 3 months after the onset of ocular inflammation. Inclusion bodies or Chlamydial DNA can persist in conjunctival cells. Anderson suggested that a recurrence of active Chlamydial infection may be induced by external causes, which lead to reconstitution of elementary bodies from the persisting DNA. The extraordinary immune situation of our patients might be one cause of the recurrent conjunctivitis.

Topics: Adult; Chlamydia trachomatis; Conjunctiva; Conjunctivitis, Inclusion; Drug Therapy, Combination; Erythromycin; Female; Follow-Up Studies; Humans; Infant, Newborn; Male; Middle Aged; Recurrence; Tetracycline

Topics: Conjunctivitis, Inclusion; Erythromycin; Humans; Infant, Newborn; Ophthalmia Neonatorum; Silver Nitrate; Tetracycline

Topics: Conjunctivitis, Bacterial; Conjunctivitis, Inclusion; Erythromycin; Female; Gonorrhea; Humans; Infant, Newborn; Ophthalmic Solutions; Pregnancy; Silver Nitrate; Tetracycline

In four patients with an adult chlamydial ophthalmia small, marginal corneal abscesses were detected. These corneal abscesses were associated with unilateral papillary and follicular conjunctivitis and punctate keratitis. In these patients no bacteria was isolated from the abscesses, but Chlamydia trachomatis was isolated from materials collected from the abscesses and from the conjunctival swabbings. In addition all patients had microbiologically proved concomitant chlamydial genital infections. The clinical signs resolved after topical treatment with rifampicin or tetracycline eye ointment for six weeks or systemic treatment with tetracycline for two weeks. Because of concomitant chlamydial genital infection it is advisable to treat patients with adult chlamydial ophthalmia with systemic tetracycline and to refer these patients and their consorts for investigation and treatment of their genital infection.

Topics: Abscess; Adult; Chlamydia Infections; Chlamydia trachomatis; Conjunctivitis, Inclusion; Corneal Diseases; Female; Humans; Keratitis; Male; Middle Aged; Rifampin; Tetracycline

The use of fluorescein-conjugated monoclonal antibody (Syva, UK) provided a rapid reliable diagnostic test for Chlamydia trachomatis in conjunctival samples from 100 adults with acute follicular conjunctivitis and seven babies with suspected chlamydial ophthalmia neonatorum. Elementary bodies (EBs) were seen in smears from 11 of the adults, and culture confirmed C. trachomatis infection in nine of them. Both tests were positive with specimens from four of the neonates. No specimens from either group of patients produced a negative result in the smear test but a positive result by culture. However, the two adult patients with chlamydial ophthalmia who had negative cultures but were EB-positive had both had prior topical tetracycline therapy.

Topics: Adult; Antibodies, Monoclonal; Bacterial Outer Membrane Proteins; Chlamydia trachomatis; Conjunctivitis, Inclusion; Female; Humans; Infant, Newborn; Male; Ophthalmia Neonatorum; Tetracycline

Without preventive measures, gonococcal ophthalmia will develop in approximately 28% of infants born to women with gonorrhea, a disease that is relatively frequent and largely asymptomatic in pregnant women. In addition, in some settings conjunctivitis caused by Chlamydia trachomatis may be more frequent than gonococcal conjunctivitis among neonates. The Canadian Paediatric Society therefore recommends that, as soon as possible after birth, all infants receive prophylaxis with silver nitrate, tetracycline or erythromycin, administered according to specific guidelines.

Topics: Conjunctivitis, Inclusion; Erythromycin; Female; Gonorrhea; Humans; Infant, Newborn; Ointments; Ophthalmia Neonatorum; Ophthalmic Solutions; Penicillin G; Pregnancy; Pregnancy Complications, Infectious; Silver Nitrate; Tetracycline

Topics: Conjunctivitis, Inclusion; Erythromycin; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Tetracycline

Chlamydiae are obligate intracellular parasites, bacteria with a peculiar biology. They belong to the genus Chlamydia which includes two species: C. psittaci and C. trachomatis. A wide range of hosts, including birds, mammals and man can be infected by chlamydiae. The diseases chlamydiae can produce include psittacosis, lymphogranuloma venereum, trachoma, inclusion conjunctivitis, urethritis, cervicitis, pelvic inflammatory disease, and neonatal pneumonia. The diagnosis of chlamydial infection may be made by visualization of the organism in direct smears, isolation of the agent in cell culture, or by demonstrating a significant rise in antibody titer. Chlamydial infection may be treated with tetracycline, erythromycin, or sulfonamides.

Topics: Adult; Arthritis, Reactive; Child; Chlamydia Infections; Conjunctivitis, Inclusion; Epididymitis; Erythromycin; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Lymphogranuloma Venereum; Male; Pelvic Inflammatory Disease; Pneumonia; Sexually Transmitted Diseases; Tetracycline; Trachoma; Urethritis; Uterine Cervicitis

We obtained cultures for bacteria and chlamydiae from 100 infants with conjunctivitis that began during the first month of life. Sixty-nine infants were evaluated during well-child visits (group A); 31 were seen specifically for the ocular discharge (group B). Potentially pathogenic bacteria, predominantly Staphylococcus aureus, were cultured from one third of the infants in each group. Chlamydia trachomatis was recovered from three infants (4%) in group A and from ten (32%) in group B. Three infants with chlamydial conjunctivitis (two in group A, one in group B) had only mild inflammation. Initial treatment with topical antibiotics was unsuccessful in eliminating the organism from seven of 11 infants.

Topics: Conjunctivitis; Conjunctivitis, Inclusion; Erythromycin; Follow-Up Studies; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Staphylococcal Infections; Sulfisoxazole; Tetracycline

The most frequently seen type of infectious ophthalmia neonatorum, inclusion conjunctivitis, is caused by the organism Chlamydia trachomatis. This agent is known to be transmitted sexually. Until recently, the infections produced by C trachomatis were though to be relatively benign. Recent evidence, however, suggests that the organism may produce urethritis and epididymitis in the male; cervicitis, cervical erosions, salpingitis, and puerperal infections in the female; and prematurity and pneumonitis in the infant. An infant who develops ophthalmia neonatorum should be thoroughly evaluated for the presence of a chlamydial infection. In many instances the first evidence of chlamydial infection within the parents will be the development of inclusion conjunctivitis in their newborn infant. Family members of infants with inclusion conjunctivitis who manifest any evidence of clinical disease should be evaluated and treated with appropriate antibiotics.

Topics: Adult; Chlamydia Infections; Chlamydia trachomatis; Conjunctivitis, Inclusion; Female; Humans; Infant, Newborn; Male; Ophthalmia Neonatorum; Salpingitis; Tetracycline; Urethritis

Topics: Anti-Bacterial Agents; Chlortetracycline; Conjunctivitis, Inclusion; Drug Evaluation; Erythromycin; Humans; Oleandomycin; Sulfanilamides; Tetracycline

Topics: Anti-Bacterial Agents; Chlamydia Infections; Chlamydia trachomatis; Conjunctivitis, Inclusion; Drug Therapy, Combination; Humans; Infant, Newborn; Infant, Newborn, Diseases; Tetracycline

In the United States, chlamydial (TRIC) agents cause a small but important segment of infectious ocular disease. Elsewhere in the world, trachoma still represents the single greatest cause of blindness. The description of these diseases in this chapter is a brief introduction to a subject about which volumes have been and will continue to be written. Barring unforeseen developments, these agents will continue to plague humankind beyond the end of the twentieth century.

Topics: Chlamydia Infections; Chlamydia trachomatis; Conjunctivitis, Inclusion; Erythromycin; Eye Diseases; Humans; Infant, Newborn; Sulfonamides; Tetracycline; Trachoma

Topics: Chlamydia; Chlamydia Infections; Complement Fixation Tests; Conjunctivitis; Conjunctivitis, Inclusion; Erythromycin; Eye Diseases; Fluorescent Antibody Technique; Humans; Sulfacetamide; Sulfonamides; Tetracycline; Trachoma

Topics: Animals; Antigens; Chlamydia; Conjunctivitis, Inclusion; Humans; Sulfonamides; Tetracycline; Trachoma

Topics: Child, Preschool; Chlamydia; Conjunctivitis, Inclusion; Cornea; Humans; Hygiene; Infant, Newborn; Infant, Newborn, Diseases; Keratoconjunctivitis; Tetracycline; Trachoma

Topics: Chlamydia; Conjunctivitis; Conjunctivitis, Inclusion; Drug Combinations; Eye Diseases; Humans; Ointments; Oleandomycin; Tetracycline; Trachoma

Topics: Conjunctiva; Conjunctivitis, Inclusion; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Male; Ophthalmoscopy; Sulfacetamide; Tetracycline

Topics: Chlamydia; Conjunctivitis, Inclusion; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Tetracycline; Trachoma

Topics: Arthritis, Reactive; Chlamydia; Chlamydia Infections; Conjunctivitis, Inclusion; Female; Humans; Male; Sulfonamides; Tetracycline; Trachoma; United Kingdom; Urethritis; Uterine Cervicitis

Topics: Animals; Conjunctivitis, Inclusion; Guinea Pigs; Placebos; Surface-Active Agents; Tetracycline

Topics: Animals; Bacitracin; Chlamydia; Chlamydophila psittaci; Complement Fixation Tests; Conjunctivitis; Conjunctivitis, Inclusion; Dihydrostreptomycin Sulfate; Fluorescent Antibody Technique; Guinea Pigs; Pharmacology; Psittacosis; Research; Sulfadiazine; Tetracycline; Tissue Culture Techniques; Trachoma; Virus Cultivation