Rapid resolution of toxoplasma chorioretinitis treatment using quadruple therapy
Authors Kartasasmita A, Muntur WP, Enus S, Iskandar E
Received 11 August 2017
Accepted for publication 8 November 2017
Published 1 December 2017 Volume 2017:11 Pages 2133—2137
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Arief Kartasasmita, Wendy P Muntur, Sutarya Enus, Erwin Iskandar
Faculty of Medicine, Universitas Padjadjaran, Cicendo National Eye Hospital, Bandung, Indonesia
Purpose: To compare the effectiveness of quadruple-drug therapy consisting of cotrimoxazole (trimethopin and sulfamethoxazole), clindamycin antibiotics, and oral corticosteroid versus triple therapy consisting of pyrimetamine, sulphadiazine, and oral corticosteroid in the resolution of toxoplasmic chorioretinitis.
Methods: This was a double-blind randomized controlled trial with repeated measures using parallel design to compare the effectiveness of quadruple-drug therapy and triple-drug therapy in patients with toxoplasmic chorioretinitis. The measurement of lesion was done using automated computer software, calculating the average of lesion size from three fundus photographs taken from the baseline and at each follow-up visit. The analytical statistics were obtained using Mann–Whitney test, comparing percentage of lesion remission test in each examination.
Results: The percentage of lesion remission in quadruple-drug therapy was higher than in triple-drug therapy from the first visit until the first follow-up visit, with a p-value of 0.001. In addition, the mean percentage of lesion remission from first visit to last visit was 57.5% and the median was 70.9% in the quadruple therapy group, while in the triple-drug therapy group the mean was 52.5% and the median was 54.0% (p=0.720).
Conclusion: We conclude that the quadruple-drug therapy has a more rapid resolution effect on chorioretinitis lesion compared to triple therapy.
Keywords: toxoplasma chorioretinitis, quadruple-drug therapy, triple-drug therapy
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