Chlamydial conjunctivitis in contact lens wearers: successful treatment with single dose azithromycin.

PURPOSE: To reveal clinical presentations of chlamydial conjunctivitis in contact lens wearers as well as to evaluate the clinical and microbiological efficacy of oral azithromycin in the treatment of this condition.

METHODS: Twenty contact lens users with chlamydial conjunctivitis were included in this retrospective study. Chlamydial infection was diagnosed by isolation of Chlamydia trachomatis in cell culture of conjunctival scrapings. All patients were treated with a single 1 g oral dose of azithromycin. Follow-up clinical and microbiological examinations were performed 1 month after treatment.

RESULTS: All patients suffered from some ocular symptoms such as itching, burning, tearing, and nonspecific irritation, but none had apparent conjunctival injection or any conjunctival discharge. The majority (90%) had bilateral complaints. Mild follicular reaction, limited to the lateral part of lower fornices, was present in 17 patients; the remaining patients had normal biomicroscopical findings. Four weeks following the single azithromycin dose, C. trachomatiswas eradicated in all patients and 17 (85%) were free of symptoms.

CONCLUSION: Chlamydial infection should be considered more frequently in differential diagnosis of symptomatic contact lens wearers. Azithromycin is the most promising agent for the treatment of chlamydial conjunctivitis due to its excellent bacteriological efficacy and very convenient single dose administration.