Skip to 0 minutes and 13 secondsHello and welcome to week 3. This week, we will discuss antibiotics and, specifically, Azithromycin as the "A" component of the SAFE strategy. Azithromycin is given to the whole eligible population of trachoma endemic communities in order to treat chlamydial infection and to interrupt trachoma transmission. The strategy for antibiotic distribution is called Mass Drug Administration or MDA. And MDA has been used to treat several endemic infections, including onchocerciasis and lymphatic filariasis. Azithromycin, whose trade name is Zithromax, is donated by Pfizer for trachoma control as part of the SAFE strategy. International NGOs partner with ministries of health to obtain the antibiotic and also to support the logistics of MDA.

Skip to 1 minute and 16 secondsThis week we will discuss which communities require azithromycin, who is eligible to receive it, the frequency and duration of treatment, and how to achieve high MDA coverage while ensuring accountability and safety of the medicine. Please look out for information on the Google Hangout and join us online if you can. Or you can post your questions and follow the recording at your own convenience.

Welcome to week 3: A is for antibiotics

Antibiotics are used to reduce chlamydial infection and break the cycle of reinfection with trachoma in endemic communities. There are some practical challenges with antibiotic treatment:

  • What dosage is required to totally eliminate the chlamydia infection?
  • Can it be a single dose or do we have to carry out repeated treatments?
  • What level of compliance is needed to achieve complete treatment?
  • Once the antibiotic is stopped, what is the likelihood of trachoma occurring again?

For many years, topical tetracycline ointment was the most realistic option for trachoma. However, following many decades of rigorous research, azithromycin is now preferred as the treatment of choice for trachoma.

Azithromycin is given as a safe (non-toxic) single oral dose. It is ideal for mass distribution as there is no need for an individual diagnosis and treatment can be given by primary health workers and volunteers. In addition, azithromycin is a broad spectrum antibiotic and treats respiratory, skin and genital infections at the same time. It is generally well accepted by communities.

In a trachoma endemic region, repeated mass treatment is needed to achieve sustained impact and break the cycle of transmission and reinfection. And it must also be accompanied by the other components of the SAFE strategy to fully eliminate blinding trachoma.

This week, we look closely at the importance of identifying who and how to treat, when to coordinate and manage mass distribution and, importantly, knowing when to stop.

Live Q&A

Anthony Solomon (WHO), Paul Emerson (ITI) and our lead educator Allen Foster (LSHTM) will discuss strategies for mass distribution of antibiotics for trachoma elimination in a live Q&A event on Thursday October 20th at 12:30pm UCT.

The Q&A will be streamed live on YouTube.

Send them your questions on mass treatment ahead of the event by commenting on step 3.11 MDA strategies.

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This video is from the free online course:

Eliminating Trachoma

London School of Hygiene & Tropical Medicine

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