A Single-Blinded Randomized Clinical Trial Comparing Polymyxin B-Trimethoprim and Moxifloxacin for Treatment of Acute Conjunctivitis in Children

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• 作者：Lee Williams ; DO¹ ; ^&lowast ; ; Yogangi Malhotra ; MD¹ ; ⁵ ; ^&lowast ; ; Barbra Murante ; NP¹ ; Susan Laverty ; RN¹ ; Steve Cook ; MD¹ ; David Topa ; MD¹ ; ² ; Dwight Hardy ; PhD³ ; Hongyue Wang ; PhD⁴ ; Francis Gigliotti ; MD¹ ; ³ ; ^{francis_gigliotti@urmc.rochester.edu}
• 关键词：MIC ; Minimal inhibitory concentration
• 刊名：The Journal of Pediatrics
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：162
• 期：4
• 页码：857-861
• 全文大小：229 K

文摘

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Objective

To perform a randomized controlled trial comparing moxifloxacin hydrochloride with polymyxin B-trimethoprim for the treatment of acute conjunctivitis.

Study design

Patients ages 1-18 years old with acute conjunctivitis had cultures performed and were randomized to receive either moxifloxacin hydrochloride or polymyxin B-trimethoprim ophthalmic solution for 7 days. Response to treatment was determined by phone query on day 4-6 and by examination with post-treatment conjunctival culture on day 7-10.

Results

One hundred and twenty-four patients were enrolled. Eighty patients (65 % ) had recognized pathogens (55 Haemophilus influenzae, 22 Streptococcus pneumoniae, 4 Moraxella catarrhalis) isolated from their conjunctiva. One hundred fourteen (56/62 moxifloxacin and 58/62 polymyxin B-trimethoprim) completed the 4-6 day evaluation, with 43/56 (77 % ) of the moxifloxacin group and 42/58 (72 % ) of the polymyxin B-trimethoprim group clinically cured according to parents (noninferiority test P?=?.04). Eighty-nine (39/56 moxifloxacin and 50/58 polymyxin B-trimethoprim) patients completed the 7-10 day evaluation. Clinical cure was observed in 37/39 (95 % ) of the moxifloxacin and 49/51 (96 % ) of the polymyxin B-trimethoprim treated groups (noninferiority test P?¡Ü?.01). Clinical cure rates for culture positive and negative conjunctivitis were not different. There was no statistically significant difference in bacteriologic cure rates between the 2 groups.

Conclusions

Polymyxin B-trimethoprim continues to be an effective treatment for acute conjunctivitis with a clinical response rate that does not differ from moxifloxacin. Use of polymyxin B-trimethoprim for the treatment of conjunctivitis would result in significant cost savings compared with fluoroquinolones.