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Oral v Topical Erythromycin Therapies for Chlamydial Conjunctivitis

Oral v Topical Erythromycin Therapies for Chlamydial Conjunctivitis Abstract • Results of oral and topical erythromycin therapy in 41 infants under 4 months of age with chlamydial conjunctivitis were evaluated in a randomized clinical trial. After three weeks of treatment, relapse or reinfection of the eye occurred in four of 19 patients (21%) in the topical therapy group and in three of 22 patients (13.6%) in the oral therapy group (P>.69). In the topical therapy group, chlamydiae were isolated from nasopharyngeal cultures of eight patients (42%) during or after therapy. Chlamydiae were eradicated from the nasopharynx of the six colonized patients treated with oral erythromycin. All relapses responded to a course of oral erythromycin therapy. We conclude that both modes of therapy are comparable for treatment of chlamydial conjunctivitis, but that oral therapy has the advantage of eradicating nasopharyngeal colonization. (Am J Dis Child 1982;136:817-821) References 1. Armstrong JH, Zacarias F, Rein MF: Ophthalmia neonatorum: A chart review . Pediatrics 1976;57:884-892. 2. Goscienski PJ: Inclusion conjunctivitis in the newborn infant . J Pediatr 1970;77:19-26.Crossref 3. Alexander ER: Chlamydia: The organism and neonatal infection . Hosp Pract 1979;14:63-69. 4. Chandler JW, Alexander ER, Pheiffer TA, et al: Ophthalmia neonatorum associated with maternal chlamydial infections . Trans Acad Ophthalmol Otolaryngol 1977;83:302-308. 5. Hammerschlag MR, Anderka M, Semine DZ, et al: Prospective study of maternal and infantile infection with Chlamydia trachomatis . Pediatrics 1979;64:142-148. 6. Schachter J, Grossman M, Holt J, et al: Prospective study of chlamydial infection in neonates . Lancet 1979;2:377-379.Crossref 7. Lumicao GG, Gyves MT, Stuart LA, et al: Prospective study of perinatal infection with Chlamydia trachomatis . Pediatr Res 1979; 13:464. 8. Frommell GT, Rothenberg R, Wang SP, et al: Chlamydial infection of mothers and their infants . J Pediatr 1979;95:28-32.Crossref 9. Podgore JK, Belts R, Alden E, et al: Effectiveness of maternal third trimester erythromycin in prevention of infant Chlamydia trachomatis infection, abstract 524. Programs and abstracts of the 20th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, Sept 22-24, 1980. 10. Hammerschlag MR, Chandler JW, Alexander ER, et al: Erythromycin for ocular prophylaxis of neonatal chlamydial infection . JAMA 1980;244:2291-2293.Crossref 11. Märdh PA, Helin I, Bobeck S, et al: Colonisation of pregnant and puerperal women and neonates with Chlamydia trachomatis . Br J Vener Dis 1980;56:96-100. 12. Thygeson P, Mengert WF: The virus of inclusion conjunctivitis: Further observations . Arch Ophthalmol 1936;15:377-410.Crossref 13. Morhorst CH, Dawson C: Sequelae of neonatal inclusion conjunctivitis and associated disease in parents . Am J Ophthalmol 1971;71:861-867. 14. Dawson CR, Wood TR, Rose L: Experimental inclusion conjunctivitis: III. Keratitis and other complications . Arch Ophthalmol 1967; 78:341-349.Crossref 15. Schachter J, Lum L, Gooding CA, et al: Pneumonitis following inclusion blennorrhea . J Pediatr 1975;87:779-780.Crossref 16. Beem MO, Saxon EM: Respiratory tract colonization and a distinctive pneumonia syndrome in infants infected with Chlamydia trachomatis . N Engl J Med 1977;296:306-310.Crossref 17. Rowe DS, Aicardi EZ, Dawson CR, et al: Purulent ocular discharge in neonates: Significance of Chlamydia trachomatis . Pediatrics 1979;63:628-632. 18. Heggie AD, Stuart LA: Comparison of effectiveness of topical sulfacetamide and oral erythromycin in the treatment of Chlamydia trachomatis conjunctivitis . Pediatr Res 1980; 14:558. 19. Gordon FB, Harper IA, Quan AL, et al: Detection of Chlamydia (Bedsonia) in certain infections of man: I. Laboratory procedures: Comparison of yolk sac and cell culture for detection and isolation . J Infect Dis 1969;120:451-462.Crossref 20. Treharne JD, Dwyer RSC, Darougar S, et al: Antichlamydial antibody in tears and sera and serotypes of Chlamydia trachomatis isolated from school children in Southern Tunisia . Br J Ophthalmol 1978;62:509-515.Crossref 21. Wentworth BB, Alexander ER: Isolation of Chlamydia trachomatis by use of 5-iodo-2-deoxyuridine-treated cells . Appl Environ Microbiol 1974;27:912-916. 22. Richmond SJ, Caul EO: Fluorescent antibody studies in chlamydial infections . J Clin Microbiol 1975;1:345-352. 23. Simon HJ, Yin EJ: Microbioassay of antimicrobial agents . Appl Environ Microbiol 1970;19:573-579. 24. Patamasucon P, Kaojarern S, Kusmiesz HT, et al: Pharmacokinetic evaluation of erythromycin ethylsuccinate and estolate in infants under 4 months of age . Antimicrob Agents Chemother 1981;19:736-739.Crossref 25. Siegel JD, McCracken GH, Threlkeld N, et al: Single dose penicillin prophylaxis against neonatal group B streptococcal infections . N Engl J Med 1980;303:769-775.Crossref 26. Rees E, Tait IA, Hobson D, et al: Persistence of chlamydial infection after treatment for neonatal conjunctivitis . Arch Dis Child 1981;56:193-198.Crossref 27. Beem M, Saxon E, Tipple M: Chlamydia trachomatis conjunctivitis in infants, abstract 13, Interscience Conference on Antimicrobial Agents and Chemotherapy, New York, Oct 12-14, 1977. 28. Rees E, Tait IA, Hobson D, et al: Neonatal conjunctivitis caused by Neisseria gonorrhoeae and Chlamydia trachomatis . Br J Vener Dis 1977;53:173-179. 29. Hobson D, Rees E: Chlamydial infection in neonates . N Engl J Med 1977;297:398. 30. Darougar S, Viswalingam M, Treharne J, et al: Treatment of TRIC infection of the eye with rifampin or chloramphenicol . Br J Ophthalmol 1977;61:255-259.Crossref 31. Schachter J, Dawson CR: Is trachoma an ocular component of a more generalised chlamydial infection? Lancet 1979;1:702-703.Crossref 32. Schachter J: The expanding clinical spectrum of infections with Chlamydia trachomatis . Sex Trans Dis 1977;4:116-118.Crossref 33. Jawetz E, Hann L: Chlamydial infection of neonates . J Infect Dis 1979;140:127-128.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1982.03970450059014
Publisher site
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Abstract

Abstract • Results of oral and topical erythromycin therapy in 41 infants under 4 months of age with chlamydial conjunctivitis were evaluated in a randomized clinical trial. After three weeks of treatment, relapse or reinfection of the eye occurred in four of 19 patients (21%) in the topical therapy group and in three of 22 patients (13.6%) in the oral therapy group (P>.69). In the topical therapy group, chlamydiae were isolated from nasopharyngeal cultures of eight patients (42%) during or after therapy. Chlamydiae were eradicated from the nasopharynx of the six colonized patients treated with oral erythromycin. All relapses responded to a course of oral erythromycin therapy. We conclude that both modes of therapy are comparable for treatment of chlamydial conjunctivitis, but that oral therapy has the advantage of eradicating nasopharyngeal colonization. (Am J Dis Child 1982;136:817-821) References 1. Armstrong JH, Zacarias F, Rein MF: Ophthalmia neonatorum: A chart review . Pediatrics 1976;57:884-892. 2. Goscienski PJ: Inclusion conjunctivitis in the newborn infant . J Pediatr 1970;77:19-26.Crossref 3. Alexander ER: Chlamydia: The organism and neonatal infection . Hosp Pract 1979;14:63-69. 4. Chandler JW, Alexander ER, Pheiffer TA, et al: Ophthalmia neonatorum associated with maternal chlamydial infections . Trans Acad Ophthalmol Otolaryngol 1977;83:302-308. 5. Hammerschlag MR, Anderka M, Semine DZ, et al: Prospective study of maternal and infantile infection with Chlamydia trachomatis . Pediatrics 1979;64:142-148. 6. Schachter J, Grossman M, Holt J, et al: Prospective study of chlamydial infection in neonates . Lancet 1979;2:377-379.Crossref 7. Lumicao GG, Gyves MT, Stuart LA, et al: Prospective study of perinatal infection with Chlamydia trachomatis . Pediatr Res 1979; 13:464. 8. Frommell GT, Rothenberg R, Wang SP, et al: Chlamydial infection of mothers and their infants . J Pediatr 1979;95:28-32.Crossref 9. Podgore JK, Belts R, Alden E, et al: Effectiveness of maternal third trimester erythromycin in prevention of infant Chlamydia trachomatis infection, abstract 524. Programs and abstracts of the 20th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, Sept 22-24, 1980. 10. Hammerschlag MR, Chandler JW, Alexander ER, et al: Erythromycin for ocular prophylaxis of neonatal chlamydial infection . JAMA 1980;244:2291-2293.Crossref 11. Märdh PA, Helin I, Bobeck S, et al: Colonisation of pregnant and puerperal women and neonates with Chlamydia trachomatis . Br J Vener Dis 1980;56:96-100. 12. Thygeson P, Mengert WF: The virus of inclusion conjunctivitis: Further observations . Arch Ophthalmol 1936;15:377-410.Crossref 13. Morhorst CH, Dawson C: Sequelae of neonatal inclusion conjunctivitis and associated disease in parents . Am J Ophthalmol 1971;71:861-867. 14. Dawson CR, Wood TR, Rose L: Experimental inclusion conjunctivitis: III. Keratitis and other complications . Arch Ophthalmol 1967; 78:341-349.Crossref 15. Schachter J, Lum L, Gooding CA, et al: Pneumonitis following inclusion blennorrhea . J Pediatr 1975;87:779-780.Crossref 16. Beem MO, Saxon EM: Respiratory tract colonization and a distinctive pneumonia syndrome in infants infected with Chlamydia trachomatis . N Engl J Med 1977;296:306-310.Crossref 17. Rowe DS, Aicardi EZ, Dawson CR, et al: Purulent ocular discharge in neonates: Significance of Chlamydia trachomatis . Pediatrics 1979;63:628-632. 18. Heggie AD, Stuart LA: Comparison of effectiveness of topical sulfacetamide and oral erythromycin in the treatment of Chlamydia trachomatis conjunctivitis . Pediatr Res 1980; 14:558. 19. Gordon FB, Harper IA, Quan AL, et al: Detection of Chlamydia (Bedsonia) in certain infections of man: I. Laboratory procedures: Comparison of yolk sac and cell culture for detection and isolation . J Infect Dis 1969;120:451-462.Crossref 20. Treharne JD, Dwyer RSC, Darougar S, et al: Antichlamydial antibody in tears and sera and serotypes of Chlamydia trachomatis isolated from school children in Southern Tunisia . Br J Ophthalmol 1978;62:509-515.Crossref 21. Wentworth BB, Alexander ER: Isolation of Chlamydia trachomatis by use of 5-iodo-2-deoxyuridine-treated cells . Appl Environ Microbiol 1974;27:912-916. 22. Richmond SJ, Caul EO: Fluorescent antibody studies in chlamydial infections . J Clin Microbiol 1975;1:345-352. 23. Simon HJ, Yin EJ: Microbioassay of antimicrobial agents . Appl Environ Microbiol 1970;19:573-579. 24. Patamasucon P, Kaojarern S, Kusmiesz HT, et al: Pharmacokinetic evaluation of erythromycin ethylsuccinate and estolate in infants under 4 months of age . Antimicrob Agents Chemother 1981;19:736-739.Crossref 25. Siegel JD, McCracken GH, Threlkeld N, et al: Single dose penicillin prophylaxis against neonatal group B streptococcal infections . N Engl J Med 1980;303:769-775.Crossref 26. Rees E, Tait IA, Hobson D, et al: Persistence of chlamydial infection after treatment for neonatal conjunctivitis . Arch Dis Child 1981;56:193-198.Crossref 27. Beem M, Saxon E, Tipple M: Chlamydia trachomatis conjunctivitis in infants, abstract 13, Interscience Conference on Antimicrobial Agents and Chemotherapy, New York, Oct 12-14, 1977. 28. Rees E, Tait IA, Hobson D, et al: Neonatal conjunctivitis caused by Neisseria gonorrhoeae and Chlamydia trachomatis . Br J Vener Dis 1977;53:173-179. 29. Hobson D, Rees E: Chlamydial infection in neonates . N Engl J Med 1977;297:398. 30. Darougar S, Viswalingam M, Treharne J, et al: Treatment of TRIC infection of the eye with rifampin or chloramphenicol . Br J Ophthalmol 1977;61:255-259.Crossref 31. Schachter J, Dawson CR: Is trachoma an ocular component of a more generalised chlamydial infection? Lancet 1979;1:702-703.Crossref 32. Schachter J: The expanding clinical spectrum of infections with Chlamydia trachomatis . Sex Trans Dis 1977;4:116-118.Crossref 33. Jawetz E, Hann L: Chlamydial infection of neonates . J Infect Dis 1979;140:127-128.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Sep 1, 1982

References

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