UMEM Educational Pearls

Category: Pediatrics

Title: Does purulent eye discharge need to be treated topically in pediatrics?

Keywords: conjunctivitis, pink eye, eye drops (PubMed Search)

Posted: 2/17/2023 by Jennifer Guyther, MD (Updated: 5/21/2024)
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It is often difficult to clinically differentiate between viral and bacterial conjunctivitis, but previous studies have shown that the vast majority of the discharge is bacterial. Topical antibiotics are often prescribed, but the efficacy of these antibiotics compared to no treatment has not been well studied.
This study included 88 children aged 6 months to 7 years with acute infective conjunctivitis who were randomized to receive moxifloxacin eye drops, placebo eye drops or no intervention.  Acute infective conjunctivitis was defined as conjunctival inflammation, discharge, soreness or swelling of the eyelids.  The clinical cure was significantly shorter in the moxifloxacin group compared to the no intervention group (3.8 vs 5.7 days).  Both moxifloxacin and placebo eye drops had a shorter time to clinical cure compared to placebo suggesting that placebo eye drops may be beneficial due to their washout effect.
Bottom line: Topical antibiotics for acute infective conjunctivitis were associated with significantly shorter recovery times from acute infective conjunctivitis.

References

Honkila et al.  Effect of Topical Antibiotics on Duration of Acute Infective Conjunctivitis in Children. JAMA Network Open. 2022;5(10):e2234459.