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Prospective randomized trial of trimethoprim/sulfamethoxazole versus pyrimethamine and sulfadiazine in the treatment of ocular toxoplasmosis.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Soheilian, Masoud Sadoughi, M. Ghajarnia, Mehdi Dehghan, Mohammad Hossein Yazdani, Shahin Behboudi, Hassan Anisian, Arash Peyman, Gholam A. |
| Copyright Year | 2005 |
| Abstract | OBJECTIVE To compare the efficacy of the classic treatment of ocular toxoplasmosis (pyrimethamine, sulfadiazine, and prednisolone) with a regimen consisting of trimethoprim/sulfamethoxazole (co-trimoxazole) plus prednisolone. DESIGN Prospective randomized single-blind clinical trial. PARTICIPANTS Fifty-nine patients with active ocular toxoplasmosis were randomly assigned to 2 treatment groups: 29 were treated with pyrimethamine/sulfadiazine, and 30 patients received trimethoprim/sulfamethoxazole. INTERVENTION Treatment consisted of 6 weeks' treatment with antibiotics plus steroids. Antitoxoplasmosis antibodies (immunoglobulin M [IgM] and IgG) were measured using an enzyme-linked immunosorbent assay. MAIN OUTCOME MEASURES Changes in retinochoroidal lesion size after 6 weeks' treatment, visual acuity (VA) before and after intervention, adverse drug reactions during follow-up, and rate of recurrence. RESULTS Active toxoplasmosis retinochoroiditis resolved in all patients over 6 weeks' treatment, with no significant difference in mean reduction of retinochoroidal lesion size between the 2 treatment groups (61% reduction in the classic treatment group and 59% in the trimethoprim/sulfamethoxazole group, P = 0.75). Similarly, no significant difference was found in VA after treatment between the 2 groups (mean VAs after treatment were 0.12 logarithm of the minimum angle of resolution [logMAR] [20/25] in the classic treatment group and 0.09 logMAR [20/25] in the trimethoprim/sulfamethoxazole group, P = 0.56). Adverse effects were similar in both groups, with one patient in each suffering from any significant drug side effects. The overall recurrence rate after 24 months' follow-up was 10.16%, with no significant difference between the treatment groups (P = 0.64). CONCLUSIONS Drug efficacies in terms of reduction in retinal lesion size and improvement in VA were similar in a regimen of trimethoprim/sulfamethoxazole and the classic treatment of ocular toxoplasmosis with pyrimethamine and sulfadiazine. Therapy with trimethoprim/sulfamethoxazole seems to be an acceptable alternative for the treatment of ocular toxoplasmosis. |
| File Format | PDF HTM / HTML |
| DOI | 10.1016/j.ophtha.2005.05.025 |
| PubMed reference number | 16171866 |
| Journal | Medline |
| Volume Number | 112 |
| Issue Number | 11 |
| Alternate Webpage(s) | http://www.gums.ac.ir/Upload/Modules/Contents/asset63/2005.pdf |
| Alternate Webpage(s) | https://doi.org/10.1016/j.ophtha.2005.05.025 |
| Journal | Ophthalmology |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
