Title | Effect of Azithromycin on the Ocular Surface Microbiome of Children in a High Prevalence Trachoma Area. |
Publication Type | Journal Article |
Year of Publication | 2021 |
Authors | Doan T, Gebre T, Ayele B, Zerihun M, Hinterwirth A, Zhong L, Chen C, Ruder K, Zhou Z, Emerson PM, Porco TC, Keenan JD, Lietman TM |
Journal | Cornea |
Date Published | 2021 Sep 04 |
ISSN | 1536-4798 |
Abstract | PURPOSE: The aim of this study was to evaluate the effect of the 4 times per year mass azithromycin distributions on the ocular surface microbiome of children in a trachoma endemic area. METHODS: In this cluster-randomized controlled trial, children aged 1 to 10 years in rural communities in the Goncha Seso Enesie district of Ethiopia were randomized to either no treatment or treatment with a single dose of oral azithromycin (height-based dosing to approximate 20 mg/kg) every 3 months for 1 year. Post hoc analysis of ocular surface Chlamydia trachomatis load, microbial community diversity, and macrolide resistance determinants was performed to evaluate differences between treatment arms. RESULTS: One thousand two hundred fifty-five children from 24 communities were included in the study. The mean azithromycin coverage in the treated communities was 80% (95% CI: 73%-86%). The average age was 5 years (95% CI: 4-5). Ocular surface C. trachomatis load was reduced in children treated with the 4 times per year azithromycin (P = 0.0003). Neisseria gonorrhoeae, Neisseria lactamica, and Neisseria meningitidis were more abundant in the no-treatment arm compared with the treated arm. The macrolide resistance gene ermB was not different between arms (P = 0.63), but mefA/E was increased (P = 0.04) in the azithromycin-treated arm. CONCLUSIONS: We found a reduction in the load of C. trachomatis and 3 Neisseria species in communities treated with azithromycin. These benefits came at the cost of selection for macrolide resistance. |
DOI | 10.1097/ICO.0000000000002863 |
Alternate Journal | Cornea |
PubMed ID | 34483276 |