Acute infective conjunctivitis in primary care: who needs antibiotics? An individual patient data meta-analysis

Jefferis, Joanna; Perera, Rafael; Everitt, Hazel; Weert, Henk van; Rietveld, Remco P; Glasziou, Paul; Rose, Peter W.

doi:10.3399/bjgp11x593811

Cited by 41 publications

(24 citation statements)

References 24 publications

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“…On the other hand, conjunctivitis, one of the main indications for prescription of antibacterial eye drops, is mostly of viral origin. Acute conjunctivitis is considered a self-limiting condition, and most patients get better regardless of antibiotic use [14]. Social context seems to play a role as well, because in Denmark child day care institutions often demand ongoing treatment of conjunctivitis for a child to be present.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic prescribing patterns in out-of-hours primary care: A population-based descriptive study

Huibers

Moth

Christensen

et al. 2014

Scandinavian Journal of Primary Health Care

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Objective. To describe the frequency and characteristics of antibiotic prescribing for different types of contacts with the Danish out-of-hours (OOH) primary care service. Design. Population-based observational registry study using routine registry data from the OOH registration system on patient contacts and ATC-coded prescriptions. Setting. The OOH primary care service in the Central Denmark Region. Subjects. All contacts with OOH primary care during a 12-month period (June 2010–May 2011). Main outcome measures. Descriptive analyses of antibiotic prescription proportions stratified for type of antibiotic, patient age and gender, contact type, and weekdays or weekend. Results. Of the 644 777 contacts registered during the study period, 15.0% received an antibiotic prescription: 26.1% resulted from clinic consultations, 10.7% from telephone consultations, and 10.9% from home visits. The prescription proportion was higher for weekends (17.6%) than for weekdays (10.6%). The most frequently prescribed antibiotic drugs were beta-lactamase sensitive penicillins (34.9%), antibiotic eye drops (21.2%), and broad-spectrum penicillins (21.0%). Most antibiotic eye drops (73%) were prescribed in a telephone consultation. Most antibiotics were prescribed at 4–6 p.m. on weekdays. Young infants received most antibacterial eye drops (41.3%), patients aged 5–17 years and 18–60 years received most beta-lactamase sensitive penicillins (44.6% and 38.9%, respectively), while patients aged 60 + years received most broad-spectrum penicillins (32.9% of all antibiotic prescriptions). Conclusion. Antibiotics were most often prescribed in clinic consultations, but, in absolute terms, many were also prescribed by telephone. The high prescription proportion, particularly antibacterial eye drops for young infants, suggests room for improvement in rational antibiotic use.

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Section: Discussionmentioning

confidence: 99%

Antibiotic prescribing patterns in out-of-hours primary care: A population-based descriptive study

Huibers

Moth

Christensen

et al. 2014

Scandinavian Journal of Primary Health Care

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“…16 One potential treatment strategy is to identify those patients in whom antibiotic therapy might provide the most benefit. A patient data meta-analysis undertaken by Jefferis and colleagues 17 showed that age less than 5 years is the most sensitive predictor of a positive bacterial culture. The most specific predictor was age less than 5 years with moderate symptoms and purulent discharge.…”

Section: Treatment Of Bacterial Conjunctivitismentioning

confidence: 98%

“…17 However, even in countries where guidelines exist and are accessible, antibiotic use remains high. 16 One potential treatment strategy is to identify those patients in whom antibiotic therapy might provide the most benefit.…”

Section: Treatment Of Bacterial Conjunctivitismentioning

confidence: 99%

Conjunctivitis

Alfonso

Fawley

2015

Primary Care: Clinics in Office Practice

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Conjunctivitis is the most common cause of red eye in primary care. The 3 most common types of conjunctivitis are viral, allergic, and bacterial, and they can present in either acute or chronic forms; the age of the patient, time of year and physical examination findings are paramount to distinguish the different types of conjunctivitis. Distinguishing between acute viral and bacterial conjunctivitis remains difficult. Patients with prolonged symptoms, poor response to initial management, or evidence of severe disease should be referred to ophthalmology for consultation.

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“…12 Meta-analyses have shown that topical antibiotic treatment can shorten the disease course, reduce likelihood of relapse, and decrease the risk of vision-threatening complications such as keratitis. 12,13 Topical fluoroquinolones are active against bacteria that commonly cause conjunctivitis. However, older fluoroquinolones have been associated with ocular pathogen resistance.…”

Section: Introductionmentioning

confidence: 99%

Gatifloxacin 0.5% Administered Twice Daily for the Treatment of Acute Bacterial Conjunctivitis in Patients One Year of Age or Older

HellerWarren

CruzMarilou²,

Rusi

et al. 2014

Journal of Ocular Pharmacology and Therapeutics

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Acute infective conjunctivitis in primary care: who needs antibiotics? An individual patient data meta-analysis

Cited by 41 publications

References 24 publications

Antibiotic prescribing patterns in out-of-hours primary care: A population-based descriptive study

Antibiotic prescribing patterns in out-of-hours primary care: A population-based descriptive study

Conjunctivitis

Gatifloxacin 0.5% Administered Twice Daily for the Treatment of Acute Bacterial Conjunctivitis in Patients One Year of Age or Older

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