Antibióticos sistémicos para retinocoroiditis por toxoplasmosis. Revisión sistemática de la literatura

Objective: The main objective of this systematic review is to evaluate safety and efficacy of systemic antibiotics in active toxoplasmic retinochoroiditis. Methods: An important search was conducted which included randomized or quasi-randomized controlled clinical trials. Studies carried out in immunocompromised patients were excluded. Studies of patients treated for acute retinochoroiditis or patients with inactive retinochoroidal scars and a history of two or more recurrent episodes of active disease were included. Well-known antibiotic regimens (trimethoprim/sulfamethoxazole, pyrimethamine/sulfadiazine, pyrimethamine/azithromycin), which have been widely used against Toxoplasma gondii, were included. Results: The primary outcomes for this review were visual acuity and recurrences, defined as a new focus of inflammation next to a preexisting scar. Secondary outcomes were adverse effects, reduction of retinochoroidal lesion size and duration, severity and frequency of signs and symptoms due to intraocular inflammation. Conclusions: There is still a lack of evidence to support the antibiotic and optimal dosage for the treatment of toxoplasmic retinochoroiditis, as well as the best prophylactic treatment for recurrences.