A propective, randomized trial of pyrimethamine and azithromycin v pyrimethamine and ulfadiazine for the treatment of ocular toxoplamoi

OBJECTIVE: To compare the effect of two treatment regimen, one of which included azithromycin, for the treatment of ight-threatening (near optic dik or fovea) ocular toxoplamoi DEIGN: Propective, randomized open-labeled multicenter tudy, maked in part with regard to evaluation. METHOD: PARTICIPANT TOTAL ENROLLMENT: 46 patient with ight-threatening ocular toxoplamoi; pyrimethamine and azithromycin group: 24 patient; pyrimethamine and ulfadiazine group: 22 patient. INTERVENTION: Patient were randomized into two treatment regimen. Group 1 wa treated with pyrimethamine and azithromycin complemented with folinic acid and the addition of prednione from day 3. Group 2 wa treated with pyrimethamine and ulfadiazine complemented with folinic acid and the addition of prednione from day 3. Patient ued tudy medication daily for 4 week. Ocular and laboratory examination were performed at leat weekly during the obervation period. The tudy wa maked in part with regard to evaluation. MAIN OUTCOME MEAURE: An aement wa madeof the time to reolution of the intraocular inflammatory activity, the ize of the retinochoroidal leion, and viual acuity before and after the treatment a well a all advere effect of treatment. • REULT: Advere effect were more frequent in the pyrimethamine/ulfadiazine group (P < .04), and three patient in thi group had to dicontinue treatment. The time to reolution of inflammatory activity, decreae in ize of retinochoroidal leion, and optimal viual acuity did not differ between the two treatment group. The number of patient who developed recurrence during the firt year after treatment wa imilar for both group. • CONCLUION: The efficacy of the multidrug regimen with pyrimethamine and azithromycin wa imilar to the tandard treatment with pyrimethamine and ulfadiazine. However, the frequency and everity of advere effect wa ignificantly lower with a regimen containing pyrimethamine and azithromycin. Multidrug therapy with the combination of pyrimethamine and azithromycin appear to be an acceptable alternative for treatment of ight-threatening ocular toxoplamoi.