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Antibiotics in infectious conjunctivitis: what comes from evidence-based medicine?

Poster Details

First Author: A.Grzybowski POLAND

Co Author(s):    M. Gaca-Wysocka              

Abstract Details



Purpose:

1. To examine the role of antibiotics comparing to placebo in the treatment of infectious conjunctivitis and 2. to evaluate the criteria for best antibiotic choice

Setting:

Hospital

Methods:

Conjunctivitis is one of the most common ocular problems in primary care and one of most common indications for antibiotic use. The growing evidence of increasing bacterial resistance justifies the re-consideration of the used treatment practices and rationalize the use of antibiotics. Antibiotics are effective only against bacteria, while more than 80% of conjunctivitis is of viral origin, and both forms are often difficult to distinguish. PubMed platform search and analysis of the controlled randomized trials (RCTs) comparing the use of antibiotics to placebo in antibiotics and conjunctivitis and RCTs comparing the effectiveness of different antibiotics in conjunctivitis.

Results:

1. More than 60% of acute bacterial conjunctivitis are self-limiting within 1 to 2 weeks of presentation. The large meta-analysis of 11 RCTs including a total of 3673 participants shown that antibiotics improved clinical risk ratio and microbiological remission rates in days two to five, but this effect was in days six to 10. There was about 10 % difference in the rate of clinical improvements between both groups. 2. There is no important difference in clinical effect between broad-spectrum antibiotic eyedrops used in the treatment of conjunctivitis. 3. There is no rationale to use antibiotics in virus conjunctivitis.

Conclusions:

Although acute bacterial conjunctivitis is frequently self-limiting, the use of topical antibiotics might be considered in order to speed the resolution of symptoms and infection. Antibiotics should not be used in viral conjunctivitis. We propose that due to rising problem of antibiotic resistance the use of some antibiotics, like aminoglycosides and fluorochinolones, should be limited to serious eye infections only. On the other hand, treatment of uncomplicated conjunctivitis, esp. in primary care settings should be based on antibiotics, like fusidic acid and chloramphenicol. FINANCIAL INTEREST: NONE

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