Topical antibiotics and artificial tears associated with reduced infective-conjunctivitis symptoms

Abstract

Question: Among children with infectious conjunctivitis, what is the therapeutic efficacy of topical antibiotics, compared with placebo or no antibiotics, in conjunctival symptom-duration reduction?

Design: Randomized controlled trial (RCT) and meta-analysis (MA).

Setting: RCT: Primary health care in Oulu, Finland.

Participants: RCT: 6 months – 7 years with acute infective conjunctivitis. MA: 1 month – 18 years.

Intervention: RCT: Moxifloxacin eye drops, placebo (carboxymethylcellulose sodium – artificial tears) eye drops, or no intervention.

Outcomes: RCT: Days to clinical cure. MA: Proportion of participants with conjunctival symptoms on days 3 to 6.

Main Results: RCT: 30, 27, and 31 participants were randomized to moxifloxacin, placebo, and no intervention, respectively. Moxifloxacin, compared with no intervention, significantly reduced time to cure, 3.8 vs 5.7 days, difference, −1.9 days (95%CI, −3.7 - −0.1 days). Survival analysis demonstrated that both moxifloxacin and placebo (artificial tears) significantly shortened the time to clinical cure relative to no intervention. MA: Antibiotics reduced the proportion of participants with conjunctival symptoms on days 3 to 6, odds ratio 0.59 (95%CI, 0.39 – 0.91).

Conclusions: Topical antibiotics, and artificial tears, reduced conjunctivitis symptom duration.