Chloramphenicol Treatment for Acute Infective Conjunctivitis in Children in Primary Care: A Randomized Double-Blind Placebo-Controlled Trial

Rose, P; Harnden, Anthony; Brueggemann, Angela B.; Perera, Rafael; Sheikh, Aziz; Crook, Derrick W.; Mant, David

doi:10.1016/j.jaapos.2005.11.004

Cited by 8 publications

(7 citation statements)

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“…These data support results from prior studies and also indicate some change in the types and frequency of isolates. 1,4,[17][18][19][20] Additionally, we isolated S. aureus in 2% of culture-positive cases. Although prior studies have listed this organism as either a contaminant or normal flora, 1,4,20 we believe that this could be a true pathogen.…”

Section: Discussionmentioning

confidence: 91%

Clinical Features of Bacterial Conjunctivitis in Children

Patel¹,

Diaz²,

Bennett³

et al. 2007

Acad Emergency Med

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Objectives: Conjunctivitis is a common cause of primary care and emergency department (ED) visits. There is a paucity of data in recent literature on the prevalence of pediatric bacterial conjunctivitis, and there are no evidence-based clinical guidelines for empirical treatment. The study objective was to describe clinical features most predictive of bacterial conjunctivitis.Methods: This was a prospective study in a children's hospital ED. Conjunctival swabs for bacterial culture were obtained from patients aged 1 month to 18 years presenting with red or pink eye and/or the diagnosis of conjunctivitis.Results: A total of 111 patients were enrolled over one year. Patients had a mean (AESD) age of 33.2 (AE37.5) months, and 55% were male. Eighty-seven patients (78%) had positive bacterial cultures. Nontypeable Haemophilus influenzae accounted for 82% (71/87), Streptococcus pneumoniae for 16% (14/87), and Staphylococcus aureus for 2.2% (2/87). Five clinical variables were significantly associated with a positive bacterial culture. Regression analysis revealed that the combination of a history of gluey or sticky eyelids and the physical finding of mucoid or purulent discharge had a posttest probability of 96% (95% confidence interval = 90% to 99%). Subjective scoring by physicians for a positive culture was 50.6%.Conclusions: Conjunctivitis in children is predominantly bacterial, with nontypeable H. influenzae being the most common organism. A history of gluey or sticky eyelids and physical findings of mucoid or purulent discharge are highly predictive of bacterial infection. Based on the above data, empirical ophthalmic antibiotic therapy may be appropriate in children presenting with conjunctivitis.

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Section: Discussionmentioning

confidence: 91%

Clinical Features of Bacterial Conjunctivitis in Children

Patel¹,

Diaz²,

Bennett³

et al. 2007

Acad Emergency Med

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“…Their apparent lack of impact on prescription use meant that there was no saving to the NHS drug budget nor a reduction in GP workloads. In view of the emerging evidence supporting the practice of ‘no or delayed antibiotic’ in managing most primary care cases of acute conjunctivitis the updated prescribing guidance for OTC ophthalmic chloramphenicol issued by the Royal Pharmaceutical Society was imperative and befitting . Further monitoring is needed to determine whether pharmacists have subsequently embraced non‐medicinal management such as eye bathing and postponing immediate antibiotic supply for acute bacterial conjunctivitis.…”

Section: Discussionmentioning

confidence: 99%

An investigation of prescription and over-the-counter supply of ophthalmic chloramphenicol in Wales in the 5 years following reclassification

John

Walker

2013

International Journal of Pharmacy Practice

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OTC availability increased the total quantity of ophthalmic chloramphenicol supplied in primary care compared to that seen prior to reclassification. Although growth in the sales of ophthalmic chloramphenicol OTC has stabilised and the supply pattern mirrors primary care prescribers, further work is required to investigate whether use is appropriate and whether the publication of updated practice guidance has changed this.

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“…The majority of acute infective conjunctivitis is caused by bacterial pathogens although most cases resolve spontaneously without serious adverse effects. 49,50 We assumed that topical antibiotics were prescribed for acute infective conjunctivitis in our study instead of systemic antibiotics although this has not been stated during data collection. The overall antibiotic prescribing rate for acute infective conjunctivitis in our study was 39.6% and was much lower than the 85.4% reported by Petersen and Hayward 32 in their UK study.…”

Section: Discussionmentioning

confidence: 99%