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Meta-Analysis
. 2022 Oct 3;5(10):e2234459.
doi: 10.1001/jamanetworkopen.2022.34459.

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

Minna Honkila  1   2 , Ulla Koskela  1   2 , Tero Kontiokari  3 , Marja-Leena Mattila  3 , Aila Kristo  3 , Raija Valtonen  4 , Suvi Sarlin  1   2 , Niko Paalanne  1   2 , Irma Ikäheimo  5 , Tytti Pokka  1   2 , Matti Uhari  1   2 , Marjo Renko  6 , Terhi Tapiainen  1   2   7
Affiliations
Meta-Analysis

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

Minna Honkila et al. JAMA Netw Open. .

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.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. Flow Diagram of the Randomized Clinical Trial
Figure 2.
Figure 2.. Probability of Conjunctival Symptoms in Children With Acute Infective Conjunctivitis Receiving Moxifloxacin Eye Drops, Placebo Eye Drops, or No Intervention
Both moxifloxacin and placebo eye drops significantly shortened the time to clinical cure vs no intervention (P = .02 and P = .03, respectively).
Figure 3.
Figure 3.. Flow Diagram of the Systematic Review and Meta-analysis
Figure 4.
Figure 4.. Proportions of Participants With Conjunctival Symptoms on Days 3 to 6 in Trials Comparing Antibiotics With a Placebo for Treating Acute Conjunctivitis in Children
OR indicates odds ratio.
See this image and copyright information in PMC

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References

    1. Weiss A, Brinser JH, Nazar-Stewart V. Acute conjunctivitis in childhood. J Pediatr. 1993;122(1):10-14. doi:10.1016/S0022-3476(05)83479-1 - DOI - PubMed
    1. Rietveld RP, ter Riet G, Bindels PJ, Schellevis FG, van Weert HC. Do general practitioners adhere to the guideline on infectious conjunctivitis? results of the Second Dutch National Survey of General Practice. BMC Fam Pract. 2007;8:54. doi:10.1186/1471-2296-8-54 - DOI - PMC - PubMed
    1. Gigliotti F, Hendley JO, Morgan J, Michaels R, Dickens M, Lohr J. Efficacy of topical antibiotic therapy in acute conjunctivitis in children. J Pediatr. 1984;104(4):623-626. doi:10.1016/S0022-3476(84)80566-1 - DOI - PubMed
    1. Rose PW, Harnden A, Brueggemann AB, et al. . Chloramphenicol treatment for acute infective conjunctivitis in children in primary care: a randomised double-blind placebo-controlled trial. Lancet. 2005;366(9479):37-43. doi:10.1016/S0140-6736(05)66709-8 - DOI - PubMed
    1. Sheikh A, Hurwitz B, van Schayck CP, McLean S, Nurmatov U. Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev. 2012;9(9):CD001211. doi:10.1002/14651858.CD001211.pub3 - DOI - PubMed

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