Treatment of Active Trachoma: Stage 1 (Trachomatous Inflammation — Follicular) and Stage 2 (Trachomatous Inflammation — Intense)

This protocol addresses active trachoma in its earliest inflammatory stages — presenting as follicular or intensely inflamed upper tarsal conjunctiva — where timely antibiotic treatment is indicated.

Clinical Scenario

Stage 1 · TF Trachomatous inflammation — follicular: five or more follicles visible in the upper tarsal conjunctiva. Follicles appear as whitish, grey, or yellow elevations, paler than the surrounding conjunctiva.
Stage 2 · TI Trachomatous inflammation — intense: upper tarsal conjunctiva appears red, rough, and thickened. Normally visible blood vessels are masked by diffuse inflammatory infiltration or follicles.

Treatment Approach

Management of active trachoma at these stages involves topical antibiotic therapy applied to the eye, with an oral antibiotic option reserved as a last resort when topical treatment cannot be used.

The specific agent, dosing schedule, and duration are detailed in the full structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

Stage 1: trachomatous inflammation - follicular (TF). Presence of five or more follicles in the upper tarsal conjunctiva. Follicles are whitish, grey or yellow elevations, paler than the surrounding conjunctiva.

Stage 2: trachomatous inflammation - intense (TI). The upper tarsal conjunctiva is red, rough and thickened. The blood vessels, normally visible, are masked by a diffuse inflammatory infiltration or follicles.

Failing the above, 1% tetracycline eye ointment: one application 2 times daily for 6 weeks, or, as a last resort, erythromycin PO: 20 mg/kg (max. 1 g) 2 times daily for 14 days.

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