NYMC Faculty Publications

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

Author Type(s)

Faculty

DOI

10.1016/j.jpeds.2012.09.013

Journal Title

The Journal of Pediatrics

First Page

857

Last Page

861

Document Type

Article

Publication Date

4-1-2013

Department

Pediatrics

Keywords

Adolescent, Anti-Bacterial Agents, Aza Compounds, Child, Child, Preschool, Conjunctiva, Conjunctivitis, Bacterial, Drug Therapy, Combination, Female, Fluoroquinolones, Haemophilus influenzae, Humans, Infant, Male, Moraxella catarrhalis, Moxifloxacin, Ophthalmic Solutions, Polymyxin B, Quinolines, Single-Blind Method, Streptococcus pneumoniae, Trimethoprim

Disciplines

Medicine and Health Sciences

Abstract

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 ≤ .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.

Link to Full Text

Share

COinS