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Acute infective conjunctivitis in primary care: Who needs antibiotics?
British Journal of General Practice
  • Joanna Jefferis, Newcastle University, UK
  • Rafael Perera, University of Oxford
  • Hazel Everitt, University of Southampton
  • Henk van Weert, University of Amsterdam
  • Remco Reitveld, University of Amsterdam
  • Paul P. Glasziou, Bond University
  • Peter W Rose, University of Oxford
Date of this Version
8-30-2011
Document Type
Journal Article
Publication Details

Published version

Jefferis, J., Perera, R., Everitt, H., van Weert, H., Rietveld, R., Glasziou, P., Rose, P. (2011). Acute infective conjunctivitis in primary care: Who needs antibiotics? An individual patient data meta-analysis. British Journal of General Practice, 61(590), e542-8

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© British Journal of General Practice, 2011

Abstract
Background: Acute infective conjunctivitis is a common problem in primary care, traditionally managed with topical antibiotics. A number of clinical trials have questioned the benefit of topical antibiotics for patients with acute infective conjunctivitis Aim: To determine the benefit of antibiotics for the treatment of acute infective conjunctivitis in primary care and which subgroups benefit most. Design: An individual patient data meta-analysis. Method: Relevant trials were identified and individual patient data gathered for meta-analysis and subgroup analysis. Results: Three eligible trials were identified. Individual patient data were available from all primary care trials and data were available for analysis in 622 patients. Eighty per cent (246/308) of patients who received antibiotics and 74% (233/314) of controls were cured at day 7. There was a significant benefit of antibiotics versus control for cure at seven days in all cases combined (risk difference 0.08, 95% confidence interval (CI) = 0.01 to 0.14). Subgroups that showed a significant benefit from antibiotics were patients with purulent discharge (risk difference 0.09, 95% CI = 0.01 to 0.17) and patients with mild severity of red eye (risk difference 0.10, 95% CI = 0.02 to 0.18), while the type of control used (placebo drops versus nothing) showed a statistically significant interaction (P=0.03). Conclusion: Acute conjunctivitis seen in primary care can be thought of as a self-limiting condition, with most patients getting better regardless of antibiotic therapy. Patients with purulent discharge or a mild severity of red eye may have a small benefit from antibiotics. Prescribing practices need to be updated, taking into account these results.
Citation Information
Joanna Jefferis, Rafael Perera, Hazel Everitt, Henk van Weert, et al.. "Acute infective conjunctivitis in primary care: Who needs antibiotics?" British Journal of General Practice Vol. 61 Iss. 590 (2011) p. e542-8 ISSN: 1478-5242
Available at: http://works.bepress.com/paul_glasziou/91/