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Effect of Topical Antibiotics on Duration of Acute Infective Conjunctivitis in Children: A Randomized Clinical Trial
Minna Honkila1,2, Ulla Koskela1,2, Tero Kontiokari3
1Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland.
Insights
Topical antibiotics significantly shorten symptom duration for children with acute infective conjunctivitis. This study confirms their efficacy in reducing discomfort and recovery time.
Area of Science:
- Ophthalmology
- Pediatrics
- Infectious Diseases
Background:
- Topical antibiotics are commonly prescribed for pediatric acute infective conjunctivitis, but their effectiveness is not well-established.
- There is a need to evaluate the clinical utility of antibiotic eye drops in children.
Purpose of the Study:
- To determine the efficacy of topical antibiotic eye drops in treating acute infective conjunctivitis in children.
- To compare antibiotic therapy with placebo and no intervention.
Main Methods:
- A randomized clinical trial involving children aged 6 months to 7 years with acute infective conjunctivitis.
- A meta-analysis combining data from the trial with three previous studies, including pediatric patients up to 18 years.
- Participants received moxifloxacin eye drops, placebo, or no intervention, with outcomes assessed over 14 days.
Main Results:
- The randomized trial showed a significantly shorter time to clinical cure with moxifloxacin compared to no intervention (3.8 vs 5.7 days).
- Both moxifloxacin and placebo eye drops shortened the time to clinical cure compared to no intervention in survival analysis.
- The meta-analysis of 584 children revealed that topical antibiotics significantly reduced conjunctivitis symptoms on days 3-6 compared to placebo (OR, 0.59; 95% CI, 0.39-0.91).
Conclusions:
- Topical antibiotics are associated with a significantly shorter duration of conjunctival symptoms in children with acute infective conjunctivitis.
- The findings support the use of topical antibiotics for managing this common pediatric condition.
- This evidence strengthens the rationale for prescribing antibiotic eye drops in pediatric cases of infective conjunctivitis.
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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