Purpose
To evaluate the efficacy and safety of trimethoprim/sulfamethoxazole and azithromycin combination for the treatment of presumed ocular toxoplasmosis.
Methods
Sixteen patients, treated for presumed ocular toxoplasmosis (OT), from september 2012 to january 2014, in a tertiary referral hospital’s Ophtalmology department, were retrospectively reviewed.<br /> The treatment consisted on an association :Trimethoprim -Sulfamethoxazole 2 times daily (160mg / 800mg for 6 weeks) and azithromycin (500mg the first day followed by 250 mg for 5 weeks)<br /> Corticosteroids: 48 hours after the beginning of treatment according to the associated inflammatory signs and location of retinochoroidal lesion.<br /> Main outcome measures: Changes in retinochoroidal lesion size after treatment, the time interval until resolution of inflammation, best corrected visual acuity (BCVA) before and after intervention, adverse drug reactions during follow-up, and rate of recurrence.
Results
The mean follow-up time of the patients was 20.43 ± 7.2 (range; 6-32) months. Final VA improved in all patients (100%) with a mean BCVA of 0.7 ± 0.5 (P= 0.01). Inflammatory findings began to subside within 14 ± 9.0 days. The reduction of lesion's size was seen in 75% cases; the mean lesion size was 1.6 ± 0.8 (p =0.0001).<br /> One patient (0.16%) had recurrent attack. One patient (0.16%) had side effects from therapy.
Conclusions
Trimethoprim/sulfamethoxazole and azithromycin combination seems to be effective and safe alternative therapy for the treatment of ocular toxoplasmosis.