Minocycline effects in patients with active trachoma

Abstract

Minocycline has a unique solubility in lipids and may reach therapeutic concentrations in tears and saliva. In two consecutive prospective double-masked clinical trials that were carried out in two villages in Saudi Arabia, we assessed the effects of oral minocycline in the treatment of trachoma and compared its effects with those of topical tetracycline ointment in the first study and to tetracycline ointment and placebo in the second study. A total of 178 eyes in 96 patients were included. The age range was 7 to 14 years, with a mean age of 9 years. All patients underwent complete ophthalmologic evaluation. School children were divided into two groups in a double-masked fashion. The first group received either oral minocycline or topical tetracycline 1% ointment and the second group was divided into three subgroups, each receiving one of the following therapeutic modalities: oral minocycline, topical tetracycline ointment, or placebo ointment. All patients were evaluated before initiation of therapy, at three weeks and at 12 months following treatment. Therapy was continued for a period of five weeks. These two double-masked field-based clinical trials have shown both minocycline given orally and tetracycline ointment given topically were effective in decreasing the intensity of inflammation due to trachoma. Oral minocycline was found to be equally effective as topical tetracycline ointment in the treatment of trachoma at three weeks. Minocycline, however, was found to be superior to topical tetracycline when patients were evaluated one year after therapy (p<0.05). These clinical trials have shown that long acting antibiotic agents such as minocycline is an effective therapeutic modality in the treatment of trachoma. Once a day minocycline administration assures compliance and helps in the eradication of the disease.