University of Oulu

Honkila M, Koskela U, Kontiokari T, et al. Effect of Topical Antibiotics on Duration of Acute Infective Conjunctivitis in Children: A Randomized Clinical Trial and a Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(10):e2234459. doi:10.1001/jamanetworkopen.2022.34459

Effect of topical antibiotics on duration of acute infective conjunctivitis in children : a randomized clinical trial and a systematic review and meta-analysis

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Author: Honkila, Minna1,2; Koskela, Ulla1,2; Kontiokari, Tero3;
Organizations: 1Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
2Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu, Oulu, Finland
3Children’s Mehiläinen, Oulu, Finland
4Children’s Terveystalo, Oulu, Finland
5NordLab Oulu, Oulu, Finland
6University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
7Biocenter Oulu, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
Persistent link:
Language: English
Published: American Medical Association, 2022
Publish Date: 2023-06-05


Importance: Although topical antibiotics are often prescribed for treating acute infective conjunctivitis in children, their efficacy is uncertain.

Objective: To assess the efficacy of topical antibiotic therapy for acute infective conjunctivitis.

Design, Setting, and Participants: A randomized clinical trial was conducted in primary health care in Oulu, Finland, from October 15, 2014, to February 7, 2020. Children aged 6 months to 7 years with acute infective conjunctivitis were eligible for enrollment. The participants were followed up for 14 days. A subsequent meta-analysis included the present trial and 3 previous randomized clinical trials enrolling pediatric patients aged 1 month to 18 years with acute infective conjunctivitis.

Interventions: Participants in the present randomized clinical trial were randomized to moxifloxacin eye drops, placebo eye drops, or no intervention.

Main Outcomes and Measures: The primary outcome in the present randomized clinical trial was time to clinical cure (in days); in the meta-analysis, the primary outcome was the proportion of participants with conjunctival symptoms on days 3 to 6.

Results: The randomized clinical trial included 88 participants (46 [52%] girls), of whom 30 were randomized to moxifloxacin eye drops (mean [SD] age, 2.8 [1.6] years), 27 to placebo eye drops (mean [SD], age 3.0 [1.3] years), and 31 to no intervention (mean [SD] age, 3.2 [1.8] years). The time to clinical cure was significantly shorter in the moxifloxacin eye drop group than in the no intervention group (3.8 vs 5.7 days; difference, −1.9 days; 95% CI, −3.7 to −0.1 days; P = .04), while in the survival analysis both moxifloxacin and placebo eye drops significantly shortened the time to clinical cure relative to no intervention. In the meta-analysis, a total of 584 children were randomized (300 to topical antibiotics and 284 to a placebo), and the use of topical antibiotics was associated with a significant reduction in the proportion of children who had symptoms of conjunctivitis on days 3 to 6 compared with placebo eye drops (odds ratio, 0.59; 95% CI, 0.39 to 0.91).

Conclusions and Relevance: In this randomized clinical trial and systematic review and meta-analysis, topical antibiotics were associated with significantly shorter durations of conjunctival symptoms in children with acute infective conjunctivitis.

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Series: JAMA network open
ISSN: 2574-3805
ISSN-E: 2574-3805
ISSN-L: 2574-3805
Volume: 5
Issue: 10
Article number: e2234459
DOI: 10.1001/jamanetworkopen.2022.34459
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3123 Gynaecology and paediatrics
3141 Health care science
Funding: The study was supported by the Alma and K. A. Snellman Foundation, Finland (grant to Dr Honkila) and the Foundation for Paediatric Research, Finland (grant to Dr Honkila).
Copyright information: © 2022 Honkila M et al. JAMA Network Open. This is an open access article distributed under the terms of the CC-BY License.