A new approach to prevention may offer hope to millions at risk of trachoma, the world’s leading cause of preventable blindness.

Investigators at the University of California at San Francisco compared the effects of the standard trachoma treatment, tetracycline ointment daily for 6 weeks, with a new regimen of three doses of oral azithromycin at 1-week intervals. In test villages in Egypt, the Gambia and Tanzania, infection with the causative organism, Chlamydia trachomatis, declined 60% to 90%.

Although azithromycin costs more than tetracycline ointment, investigators feel that this drawback is balanced by the higher costs of distributing and administering the tetracycline.

Antibiotic treatment is only one of several steps that must be followed in a trachoma control strategy called SAFE, which stands for: surgery for advanced disease; antibiotics to treat and prevent infections; face washing and good personal hygiene; and environmental changes such as improved access to clean water, improved sanitation and health education.