The effect of long-term intermittent trimethoprim/sulfamethoxazole treatment on recurrences of toxoplasmic retinochoroiditis. TOXOPLASMIC RETINOCHOROIDITIS: A DOUBLE BLIND THERAPEUTIC STUDY.
To determine the effect of long-term intermittent trimethoprim/sulfamethoxazole treatment on recurrences of toxoplasmic retinochoroiditis.
                Prospective randomized open-labeled interventional clinical trial.
                A total of 124 patients with a history of recurrent toxoplasmic retinochoroiditis were randomized to treatment with one tablet of trimethoprim (160 mg)/sulfamethoxazole (800 mg) (Bactrim F; Roche Pharmaceuticals, Rio de Janeiro, Brazil) every 3 days (61 patients) or to observation without treatment (63 patients) and were followed monthly for up to 20 consecutive months for clinical signs of disease recurrence. A recurrence was defined as a new focus of necrotizing retinochoroiditis with active inflammation either adjacent to or remote from preexisting retinochoroidal scars.
                Recurrences developed in four (6.6%) treated patients and in 15 (23.8%) controls (P =.01). Treatment was discontinued prematurely in four patients because of mild drug reactions.
                Long-term intermittent treatment with trimethoprim/sulfamethoxazole can reduce the rate of recurrent toxoplasmic retinochoroiditis. nan
There is a lack of evidence to support routine antibiotic treatment for acute toxoplasma retinochoroiditis. There is weak evidence to suggest that long-term treatment may reduce recurrence of retinochoroiditis in patients with chronic recurrent toxoplasma retinochoroiditis due to more virulent South American strains of Toxoplasma gondii. Placebo controlled trials of patients with acute and chronic toxoplasma retinochoroiditis affecting any part of the retina are required to determine the effectiveness of antibiotic treatment.