How do we know if we really need to put all those red eyes sent in from daycare centers and schools on antibiotics? The following study shows us why.
Bacterial Conjunctivitis in Children
Prospective study in a children’s hospital ED
Conjunctival swabs for culture were obtained from patients aged 1 mo - 18 yrs presenting with red or pink eye and/or the diagnosis of conjunctivitis
111 patients enrolled over one year
Mean age of 33.2 mos, 55% male
87 patients (78%) had positive bacterial cultures
Nontypeable H influenzae = 82%
S pneumoniae = 16%
Staphylococcus aureus = 2.2%
The combination of a history of gluey or sticky eyelids and the physical finding of mucoid or purulent discharge had a post-test probability of 96% that the infection was bacterial.(So when both these are present you definitely should treat)
And since the majority of these children (78%) had positive cultures even if they only had a pink eye it is reasonable to use empirical ophthalmic antibiotic therapy in children who present with the complaint of a pink eye.
References
Patel, P.Clinical Features of Bacterial Conjunctivitis in
Children. Academic Emergency Medicine 2007; 14:1–5a 2007
