HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

Rapid Response to:

Articles: Latha Chandran and Rachel Boykan Chlamydial Infections in Children and Adolescents Pediatrics in Review 2009; 30: 243-250 [Full text] [PDF]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Management of Chlamydia

latha chandran, Rachel Boykan   (7 August 2009)

Differences in treatment of Chlamydial neonatal conjuctivitis and Trachoma

Samuel Sheng   (7 July 2009)

Management of Chlamydia 7 August 2009
latha chandran, physician PIR, Rachel Boykan Send letter to journal: Re: Management of Chlamydia sydney_sutherland{at}urmc.rochester.edu latha chandran, et al.	Serovars A-K are predominantly responsible for ocular infections due to Chlamydia trachomatis. The pathophysiology of ophthalmia neonatorum as per the AAP Red Book(1) is characterized by “ocular congestion, edema and discharge” whereas trachoma is a more chronic indolent process that involves scarring and pannus formation. In neonates, the nasopharynx is the most common site of infection with Chlamydia. A significant percent of neonates who have chlamydial conjunctivitis develop pneumonia as well. In addition to the AAP recommendations, the ophthalmology literature also lists the extraocular sites of chlamydial infection in neonates and recommends systemic antibiotic therapy for neonatal inclusion conjunctivitis(2,3) For trachoma, the recommended treated is topical; however, oral macrolides are also acceptable alternatives as suggested in our table 3 (4). Trachoma is treated more as a public health problem than an individual disease; hence, the more pragmatic the approach, the better the overall community outcome. Although one study from England showed a beneficial effect in prevention of blindness using oral azithromycin compared to topical tetracycline (5), a large meta analysis found no definitive difference between these choices(6). References: 1. American Academy of Pediatrics, Committee on Infectious Diseases. Chlamydial infections. 2006 Red Book, Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 2006: 249 -257 2. Nagakawa H. Treatment of Chlamydial conjunctivitis. Ophthalmologica 1997; 211 Suppl 1:25-8 3. Yip TP, Yip KT, Que TL, Lee MM, Kwong NS, Ho CK. Incidence of neonatal chlamydial conjunctivitis and its association with nasopharyngeal colonization in a Hong Kong hospital, assessed by polymerase chain reaction. Hong Kong Med J 2007 Feb; 13(1):22:6. 4. Chandran L, Boykan R. Chlamydial Infections in Children and Adolescents. Pediatr. Rev., Jul 2009; 30: 243 – 250 5. Fraser-Hurt N, Bailey RL, Cousens S, Mabey D, Faal H, Mabey DC. Efficacy of oral azithromycin versus topical tetracycline in mass treatment of endemic trachoma. Bull World Health Organ. 2001;79(7):632-40 Mabey D, Fraser-Hurt N, Powell C. Antibiotics for trachoma. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD001860. DOI: 10.1002/14651858 Conflict of Interest: None declared
Differences in treatment of Chlamydial neonatal conjuctivitis and Trachoma 7 July 2009
Samuel Sheng, Pediatrician Cook Children's Physician Network Send letter to journal: Re: Differences in treatment of Chlamydial neonatal conjuctivitis and Trachoma ssheng{at}aap.net Samuel Sheng	Why is topical treatment of chlamydial neonatal conjunctivitis ineffective WHEREAS the opposite is true for trachoma? Conflict of Interest: None declared