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

Autor:	Honkila M; Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland.; Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland., Koskela U; Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland.; Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland., Kontiokari T; Children's Mehiläinen, Oulu, Finland., Mattila ML; Children's Mehiläinen, Oulu, Finland., Kristo A; Children's Mehiläinen, Oulu, Finland., Valtonen R; Children's Terveystalo, Oulu, Finland., Sarlin S; Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland.; Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland., Paalanne N; Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland.; Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland., Ikäheimo I; NordLab Oulu, Oulu, Finland., Pokka T; Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland.; Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland., Uhari M; Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland.; Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland., Renko M; University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland., Tapiainen T; Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland.; Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland.; Biocenter Oulu, University of Oulu, Oulu, Finland.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2022 Oct 03; Vol. 5 (10), pp. e2234459. Date of Electronic Publication: 2022 Oct 03.
DOI:	10.1001/jamanetworkopen.2022.34459
Abstrakt:	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.
Databáze:	MEDLINE
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