Literature DB >> 36194412

Effect of Topical Antibiotics on Duration of Acute Infective Conjunctivitis in Children: A Randomized Clinical Trial and a Systematic Review and Meta-analysis.

Minna Honkila1,2, Ulla Koskela1,2, Tero Kontiokari3, Marja-Leena Mattila3, Aila Kristo3, Raija Valtonen4, Suvi Sarlin1,2, Niko Paalanne1,2, Irma Ikäheimo5, Tytti Pokka1,2, Matti Uhari1,2, Marjo Renko6, Terhi Tapiainen1,2,7.   

Abstract

Importance: Although topical antibiotics are often prescribed for treating acute infective conjunctivitis in children, their efficacy is uncertain. Objective: To assess the efficacy of topical antibiotic therapy for acute infective conjunctivitis. Design, Setting, and Participants: A randomized clinical trial was conducted in primary health care in Oulu, Finland, from October 15, 2014, to February 7, 2020. Children aged 6 months to 7 years with acute infective conjunctivitis were eligible for enrollment. The participants were followed up for 14 days. A subsequent meta-analysis included the present trial and 3 previous randomized clinical trials enrolling pediatric patients aged 1 month to 18 years with acute infective conjunctivitis. Interventions: Participants in the present randomized clinical trial were randomized to moxifloxacin eye drops, placebo eye drops, or no intervention. Main Outcomes and Measures: The primary outcome in the present randomized clinical trial was time to clinical cure (in days); in the meta-analysis, the primary outcome was the proportion of participants with conjunctival symptoms on days 3 to 6.
Results: The randomized clinical trial included 88 participants (46 [52%] girls), of whom 30 were randomized to moxifloxacin eye drops (mean [SD] age, 2.8 [1.6] years), 27 to placebo eye drops (mean [SD], age 3.0 [1.3] years), and 31 to no intervention (mean [SD] age, 3.2 [1.8] years). The time to clinical cure was significantly shorter in the moxifloxacin eye drop group than in the no intervention group (3.8 vs 5.7 days; difference, -1.9 days; 95% CI, -3.7 to -0.1 days; P = .04), while in the survival analysis both moxifloxacin and placebo eye drops significantly shortened the time to clinical cure relative to no intervention. In the meta-analysis, a total of 584 children were randomized (300 to topical antibiotics and 284 to a placebo), and the use of topical antibiotics was associated with a significant reduction in the proportion of children who had symptoms of conjunctivitis on days 3 to 6 compared with placebo eye drops (odds ratio, 0.59; 95% CI, 0.39 to 0.91). Conclusions and Relevance: In this randomized clinical trial and systematic review and meta-analysis, topical antibiotics were associated with significantly shorter durations of conjunctival symptoms in children with acute infective conjunctivitis. Trial Registration: ClinicalTrialsRegister.eu Identifier: 2013-005623-16.

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Year:  2022        PMID: 36194412      PMCID: PMC9533187          DOI: 10.1001/jamanetworkopen.2022.34459

Source DB:  PubMed          Journal:  JAMA Netw Open        ISSN: 2574-3805


  9 in total

Review 1.  Antibiotics versus placebo for acute bacterial conjunctivitis.

Authors:  Aziz Sheikh; Brian Hurwitz; Constant Paul van Schayck; Susannah McLean; Ulugbek Nurmatov
Journal:  Cochrane Database Syst Rev       Date:  2012-09-12

2.  Efficacy and safety of besifloxacin ophthalmic suspension 0.6% in children and adolescents with bacterial conjunctivitis: a post hoc, subgroup analysis of three randomized, double-masked, parallel-group, multicenter clinical trials.

Authors:  Timothy L Comstock; Michael R Paterno; Dale W Usner; Michael E Pichichero
Journal:  Paediatr Drugs       Date:  2010-04-01       Impact factor: 3.022

3.  Efficacy of topical antibiotic therapy in acute conjunctivitis in children.

Authors:  F Gigliotti; J O Hendley; J Morgan; R Michaels; M Dickens; J Lohr
Journal:  J Pediatr       Date:  1984-04       Impact factor: 4.406

4.  Etiology of acute conjunctivitis in children.

Authors:  F Gigliotti; W T Williams; F G Hayden; J O Hendley; J Benjamin; M Dickens; C Gleason; V A Perriello; J Wood
Journal:  J Pediatr       Date:  1981-04       Impact factor: 4.406

5.  Acute conjunctivitis in childhood.

Authors:  A Weiss; J H Brinser; V Nazar-Stewart
Journal:  J Pediatr       Date:  1993-01       Impact factor: 4.406

6.  The Cochrane Collaboration's tool for assessing risk of bias in randomised trials.

Authors:  Julian P T Higgins; Douglas G Altman; Peter C Gøtzsche; Peter Jüni; David Moher; Andrew D Oxman; Jelena Savovic; Kenneth F Schulz; Laura Weeks; Jonathan A C Sterne
Journal:  BMJ       Date:  2011-10-18

7.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

Authors:  David Moher; Alessandro Liberati; Jennifer Tetzlaff; Douglas G Altman
Journal:  PLoS Med       Date:  2009-07-21       Impact factor: 11.069

8.  Chloramphenicol treatment for acute infective conjunctivitis in children in primary care: a randomised double-blind placebo-controlled trial.

Authors:  Peter W Rose; Anthony Harnden; Angela B Brueggemann; Rafael Perera; Aziz Sheikh; Derrick Crook; David Mant
Journal:  Lancet       Date:  2005 Jul 2-8       Impact factor: 79.321

9.  Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice.

Authors:  Remco P Rietveld; Gerben ter Riet; Patrick J E Bindels; François G Schellevis; Henk C P M van Weert
Journal:  BMC Fam Pract       Date:  2007-09-16       Impact factor: 2.497

  9 in total

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