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Topical antibiotics in acute bacterial conjunctivitis
  1. Ian Crawford, Clinical Research Fellow,
  2. Don Othoro, Senior House Officer

    Abstract

    A short cut review was carried out to establish whether there is any evidence to show if topical antibiotic therapy reduces time to remission in acute bacterial conjunctivitis. Altogether 1231 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. A clinical bottom line is stated.

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    Report by Ian Crawford,Clinical Research FellowSearch checked by Don Othoro, Senior House Officer

    Clinical scenario

    One evening after the emergency eye centre has closed you assess a patient and diagnose acute bacterial conjunctivitis. Your usual practice is to prescribe topical antibiotic therapy. Having recently attended a BestBETs course you wonder if this has been shown to reduce the time to clinical remission.

    Three part question

    In [patients with acute bacterial conjunctivitis] is [the use of topical antibiotic therapy better than placebo] at [reducing the time to clinical remission]?

    Search strategy

    Medline 1966–04/02 using the OVID interface, Cochrane Library Issue 1, 2002. Medline: (exp Chloramphenicol OR chloramphenicol.af OR exp Chlortetracycline OR chlortetracycline.af OR exp Ciprofloxacin OR ciprofloxacin.af OR exp Framycetin OR framycetin.af OR exp Fusidic acid OR fusidic acid.af OR exp Gentamicins OR gentamicin.af OR exp Neomycin OR neomycin.af OR exp Ofloxacin OR ofloxacin.af OR exp Polymyxin B OR polymyxin.af OR lomefloxacin.af OR propamidine.af OR exp Anti-Infective agents OR anti-infective agent$.af OR antib$.af) AND (exp Conjunctivitis OR conjunctiv$.af) AND maximally sensitive RCT filter AND (LIMIT to human AND English). Cochrane: (CONJUNCTIVITIS, BACTERIAL) AND (ANTIBIOTICS)

    Search outcome

    Altogether 1231 papers were found of which three were relevant and had been meta-analysed by the Cochrane Eyes and Vision Group. This review was last updated on the 27 October 1999. No further relevant papers were identified after this date. This paper is shown in table 5.

    Table 5

    Comment(s)

    The meta-analysis indicates that acute bacterial conjunctivitis is frequently a self limiting condition, as early (days 2–5) clinical remission occurred in 64% (95% CI 57% to 71%) of those treated with placebo.

    CLINICAL BOTTOM LINE

    The use of topical antibiotic therapy does reduce the time to clinical remission in patients with acute bacterial conjunctivitis.

    Report by Ian Crawford,Clinical Research FellowSearch checked by Don Othoro, Senior House Officer

    References

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