Topical antibiotics use in pediatric acute infective conjunctivitis has favorable outcomes: JAMA

Using topical antibiotics for acute infective conjunctivitis in pediatric patients has shown favorable outcomes as per a recent study that was published in the journal JAMA Network Open.  

There is uncertainty regarding the use of antibiotics for acute infective conjunctivitis in children. Hence researchers from Finland conducted a randomized clinical trial to assess the efficacy of topical antibiotic therapy for acute infective conjunctivitis. The study was carried out at 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 taken as participants in the study and followed up for 14 days. Participants were randomized to moxifloxacin eye drops, placebo eye drops, or no intervention. The primary outcome of the randomized clinical trial was time to clinical cure in days. 

A subsequent meta-analysis was done including the present trial and 3 previous randomized clinical trials enrolling pediatric patients aged 1 month to 18 years with acute infective conjunctivitis. The primary outcome of the meta-analysis was the proportion of participants with conjunctival symptoms on days 3 to 6.

Results:

• The randomized clinical trial included 88 participants including 46 girls.
• They were randomized to 3 groups of 30 patients with a mean age of 2.8 years to moxifloxacin eye drops, 27 children with a mean age of 3 years to placebo eye drops, and 31 participants with a mean age of 3.2 years who did not receive any intervention.
• 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). 
• 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 with 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. 

Thus, in this randomized clinical trial and systematic review and meta-analysis, the use of antibiotic eye drops was associated with significantly shorter durations of symptoms in children with conjunctivitis, often called pink eye. 

Further reading: 10.1001/jamanetworkopen.2022.34459 

Honkila M, Koskela U, Kontiokari T, et al. Effect of Topical Antibiotics on Duration of Acute Infective Conjunctivitis in Children: A Randomized Clinical Trial and a Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(10):e2234459