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PubMed2004

[Acute bacterial conjunctivitis].

Acute infectious conjunctivitis is the eye disease most commonly seen by general practitioners, and is estimated to represent 2-3% of their total number of consultations. The present paper gives a review of the epidemiology, etiology, clinical picture, complications, differential diagnoses and therapy of acute bacterial conjunctivitis. The condition has an excellent prognosis with a high frequency of spontaneous remission. However, topical antibacterial therapy should always be instituted, because this will shorten the course of the disease and reduce the risk of epidemic outbreaks, particularly in institutions for children.

Acute Disease↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Topical antibiotics in acute bacterial conjunctivitis.

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.

Acute Disease↗
PubMed1982

Trimethoprim-polymyxin eye drops versus neomycin-polymyxin-gramicidin eye drops in the treatment of presumptive bacterial conjunctivitis - a double-blind study.

48 patients witha diagnosis of presumptive bacterial conjunctivitis were assessed. They had been treated with either trimethoprim-polymyxin or neomycin-polymyxin-gramicidin eye drops in a randomised double-blind trial. There were 24 patients in each treatment group. There were no significant differences between the two preparations proved with regard to the eradication of organisms or clinical improvement, and both preparations proved to be very effective. Patient compliance was good and no adverse reactions were encountered with either preparation.

Adolescent↗
PubMed2005

Clinical and bacterial characteristics of acute bacterial conjunctivitis in children in the antibiotic resistance era.

BACKGROUND: Acute conjunctivitis is the most common eye disorder in young children. Bacteria are responsible for 54-73% of all cases. The goals of the study were to identify the rates of Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis in cases of bacterial conjunctivitis in children and to define antibiotic resistance rates. METHODS: During a 2-year study period, conjunctival swabs of children 2-36 months old were collected prospectively. Nontypable H. influenzae, S. pneumoniae and M. catarrhalis were defined as the study pathogens. Analyzed variables included demography, clinical presentation, bacteriologic results and susceptibility patterns. RESULTS: There were 428 patients enrolled. Of all cultures, 55% (237 of 428) yielded at least 1 of the study pathogens. H. influenzae and S. pneumoniae were isolated from 29 and 20% of cultures, respectively. beta-Lactamase production was found in 29% of H. influenzae isolates, and penicillin nonsusceptibility was observed in 60% of S. pneumoniae isolates. The most common S. pneumoniae serotypes were: 19F (14%); 6A and 14 (11% each). Nontypable S. pneumoniae was found in 12%. The 7-valent pneumococcal conjugate vaccine (PCV-7) could potentially cover 44% of all isolates. Conjunctivitis-otitis syndrome was found in 32% of patients, of whom 82% of cultures yielded H. influenzae. CONCLUSIONS: Antibiotic resistance rates are alarmingly high. Conjunctivitis-otitis syndrome, predominantly caused by H. influenzae, is quite common. The potential coverage of the PCV-7 in conjunctivitis is relatively lower than that reported in other pneumococcal infections. Our findings should alert physicians on the choice of appropriate antibiotic treatment, on the frequent copresence of acute otitis media and on the potential role of conjunctivitis in the spread of antibiotic-resistant pathogens.

Acute Disease↗
PubMedDate not supplied

Results of a survey of children with acute bacterial conjunctivitis treated with trimethoprim-polymyxin B ophthalmic solution.

Acute conjunctivitis, one of the most frequently seen eye diseases in infants and children, is associated with a shorter duration of clinical disease when antimicrobial agents are used. Although viruses often are implicated as causative agents, Haemophilus influenzae and Streptococcus pneumoniae are the most commonly isolated bacterial pathogens. Empiric therapy of acute conjunctivitis therefore should include agents with both gram-positive and gram-negative antimicrobial activity. Trimethoprim-polymyxin B is a broad-spectrum antimicrobial agent available as an ophthalmic solution. We conducted a patient outcomes study to evaluate the subjective response to treatment with trimethoprim-polymyxin B of children with presumed acute bacterial conjunctivitis. Questionnaires were distributed to more than 100 pediatricians who assessed outcome measures in 472 children with acute bacterial conjunctivitis for whom they prescribed trimethoprim-polymyxin B. The parameters evaluated were clinical outcome, overall efficacy, and comfort provided by the medication regimen. The physicians reported that 95% of the infected eyes were cured or improved within 7 days. In addition, the overall efficacy trimethoprim-polymyxin B was rated as excellent or good in 76% and 20% of cases, respectively. With regard to patient comfort, patients or their caregivers reported that patients were very comfortable or moderately comfortable in 62% and 27% of cases, respectively. Four adverse events were reported; all were transient and of mild-to-moderate intensity. The survey results support clinical research findings on the comparative efficacy and safety of trimethoprim-polymyxin B ophthalmic solution compared with other ophthalmic antimicrobial agents. The pediatricians in our survey who prescribed trimethoprim-polymyxin B ophthalmic solution for children with presumed acute bacterial conjunctivitis reported that this medication was effective and well tolerated.

Acute Disease↗
PubMed1983

Trimethoprim-polymyxin B ophthalmic solution in the treatment of presumptive bacterial conjunctivitis--a multicentre trial of its efficacy versus neomycin-polymyxin B-gramicidin and chloramphenicol ophthalmic solutions.

Two-hundred and thirty patients with a diagnosis of presumptive bacterial conjunctivitis were assessed in a randomized double-blind multicentre trial. In two of the centres the patients had been treated with either trimethoprim-polymyxin B or neomycin-polymyxin B-gramicidin ophthalmic solution. In the other two centres the patients had been treated with either trimethoprim-polymyxin B or chloramphenicol ophthalmic solution. All of the preparations used were shown to be effective and very few adverse reactions were encountered. No significant difference in clinical efficacy could be demonstrated between trimethoprim-polymyxin B and neomycin-polymyxin B -gramicidin but trimethoprim-polymyxin B was found to be significantly better (P = 0.03) than chloramphenicol in reducing signs and symptoms.

Chloramphenicol↗
PubMed1991

[Sodium sulfapyridazine in new delayed-action bases for the treatment of bacterial conjunctivitis].

Possible preparation of 10 per cent sodium sulfapyridazine ophthalmic drops containing aubazidan, a microbial polysaccharide, providing prolongation of the drops action and stability on the storage was studied. The pharmacokinetic studies showed that aubazidan which is a natural polymer provided high prolongation of the sulfapyridazine effect in the tissues of the anterior part of the eye in rabbits. The prolonged effect was similar to the previously observed effect of the solutions containing synthetic polymers such as 1 per cent polyacrylamide and polyvinyl . Satisfactory tolerance by the rabbit eye tissues of 6-fold daily instillations of the 10 per cent sodium sulfapyridazine solution with aubazidan for the observation period of 1 month was stated. When stored in vials the 10 per cent sodium sulfapyridazine ophthalmic drops with 0.5 per cent of aubazidan preserved the stability for 24 months with respect to the colour, transparency, viscosity, pH and drug content. It was demonstrated with using the agar diffusion method and Staphylococcus aureus, Proteus vulgaris, Escherichia coli and Pseudomonas aeruginosa as the test cultures that sodium sulfapyridazine completely preserved its antimicrobial activity in the presence of aubazidan. The data suggested that clinical trials of the 10 per cent sodium sulfapyridazine solution with 0.2-0.5 per cent of aubazidan were promising in prevention and therapy of bacterial conjunctivitis.

Animals↗
PubMed2005

Slime-producing Staphylococcus epidermidis and S. aureus in acute bacterial conjunctivitis in soft contact lens wearers.

In recent years, an increase in ocular pathologies related to soft contact lens has been observed. The most common infectious agents were Staphylococcus spp. Some strains produce an extracellular polysaccharidic slime that can cause severe infections. Polysaccharide synthesis is under genetic control and involves a specific intercellular adhesion (ica) locus, in particular, icaA and icaD genes. Conjunctival swabs from 97 patients with presumably bacterial bilateral conjunctivitis, wearers of soft contact lenses were examined. We determined the ability of staphylococci to produce slime, relating it to the presence of icaA and icaD genes. We also investigated the antibiotic susceptibility and Pulsed Field Gel Electrophoresis (PFGE) patterns of the clinical isolates. We found that 74.1% of the S. epidermidis strains and 61.1% of the S. aureus strains isolated were slime producers and showed icaA and icaD genes. Both S. epidermidis and S. aureus slime-producing strains exhibited more surface hydrophobicity than non-producing slime strains. The PFGE patterns overlapped in S. epidermidis strains with high hydrophobicity. The similar PFGE patterns were not related to biofilm production. We found scarce matching among the Staphylococcus spp. studied, slime production, surface hydrophobicity and antibiotic susceptibility.

Adolescent↗
PubMed1999

Bacterial conjunctivitis in Muc1 null mice.

PURPOSE: In contrast to wild-type mice, genetically engineered Mucin1 (Muc1) null animals display a marked propensity for development of blepharitis and conjunctivitis. Molecular approaches confirmed the presence of Muc1 mRNA and protein in the conjunctival tissue of wild-type mice and identified the bacterial species in Muc1 null symptomatic mice. METHODS: Muc1 null animals housed in a conventional facility were examined for visually apparent inflammation of the eye and surrounding tissue. Blood taken from overtly affected animals was assayed for antibodies to common murine viral agents. Swabs of infected eyes and whole eye preparations were used to detect and speciate bacterial pathogens. Frozen sections of whole eye, lid margin, and Harderian gland were immunostained with antibodies to Muc1 and cytokeratin 14, both epithelial cell markers. Northern blot analysis and reverse transcription-polymerase chain reaction (RT-PCR) were performed on RNA isolated from conjunctiva and Harderian gland of wild-type mice to compare relative levels of transcript. RESULTS: Student's unpaired t-test performed on the eye inflammation frequency of Muc1 null mice confirmed a statistical significance (P < 0.01) when compared to wild-type background animals housed in the same room. Analysis of blood samples from affected Muc1 null animals detected no common murine viral pathogens. Bacterial analysis of conjunctival swabs and whole eye preparations demonstrated the presence of coagulase-negative Staphylococcus, Streptococcus type alpha, and Corynebacterium group G2. Muc1 antibody staining of wild-type sections revealed the presence of Muc1 on conjunctival goblet and non-goblet cells and on the epithelium of the Harderian gland. Serial sections stained with cytokeratin 14 antibody confirmed the epithelial nature of cells expressing the Muc1 protein. RNA from conjunctiva and Harderian gland subjected to RT-PCR and northern blot analysis showed an abundance of Muc1 transcript in these tissues. CONCLUSIONS: Muc1 mRNA and protein are present in murine conjunctival and Harderian gland epithelia. Animals lacking Muc1 mRNA and protein are predisposed to developing eye inflammation when compared to wild-type animals with an intact Muc1 gene. Muc1 appears to play a critical protective role at the ocular surface, presumably by acting as a barrier to infection by certain bacterial strains.

Animals↗
PubMed1975

Comparison of antibiotic therapy in presumptive bacterial conjunctivitis.

One hundred twenty patients who met criteria for presumptive bacterial infections of the conjunctiva were closely recorded for two weeks in a double-blind study that compared the effectiveness of gentamicin with a combination of neomycin and polymyxin B sulfates. The neomycin and polymyxin B combination demonstrated statistical superiority as measured by patient improvement and failure to respond to therapy. However, difficulties including chance distribution of bacteria and variability of organism resistance may have detracted from statistical results.

Anti-Bacterial Agents↗