Reuters Health Information
Azithromycin Eye Drops Effective for Purulent Bacterial Conjunctivitis in Children
By Will Boggs MD
March 31, 2014
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NEW YORK (Reuters Health) - Azithromycin 1.5% eye drops twice daily appears to clear purulent bacterial conjunctivitis in children faster than tobramycin 0.3% every two hours, according to a new study from manufacturer Laboratoires Théa.
"The short treatment with reduced eye drop instillations per day appears a very good option for pediatric bacterial conjunctivitis, especially 'in real life' when there no specific bacterial etiology suspected," Dr. Dominique Bremond-Gignac from CHU d'Amiens in France told Reuters Health by email.
Bacterial infection accounts for up to 80% of cases of conjunctivitis in children, Dr. Bremond-Gignac and colleagues write in the British Journal of Ophthalmology, online February 13. However, most topical antibiotics approved for treatment have only been studied in adults.
Dr. Bremond-Gignac and colleagues from 21 centers in eight countries compared the safety and efficacy of azithromycin 1.5% eye drops twice daily for three days with that of tobramycin 0.3% eye drops every two hours for two days, then four times daily for five days, in 203 children with purulent conjunctivitis and positive bacterial cultures.
On day 3, clinical cure rates were higher in the azithromycin group than in the tobramycin group (47.1% vs. 28.7%; p=0.013). But by day 7 there was no significant difference in clinical cure rates (89.2% versus 78.2%, respectively; p=0.077).
Both groups showed similar improvements in ocular signs on days 3 and 7, without significant differences between the groups.
The bacterial resolution rate in the worse eye on day 7 was similar in both treatment groups.
Children in all age categories tolerated both treatments well, the researchers say; the only ocular adverse events attributed to the study drug included erythema of the eyelid, eyelid edema, and ocular hyperemia.
Most patients/guardians in the azithromycin (92.3%) and tobramycin (90.5%) groups rated the eye drops as comfortable on day 3, and on day 7 investigators deemed treatment tolerability to be very satisfactory or satisfactory for 97.1% of azithromycin patients and 91.9% of tobramycin patients (p=0.076).
"Simplification of the therapy is a major benefit of this short-term twice daily regimen, confirmed by this study in a pediatric subgroup in whom instillation can be tricky," the researchers conclude.
"Some children may not tolerate the drops as sometimes it stings during instillation," Dr. Bremond-Gignac said. "This is due to the formulation that cannot be changed at this time. But usually all children complain from stinging when drops are instilled!"
Dr. Bremond-Gignac, a consultant to Laboratoires Théa, concluded that azithromycin drops offer "short treatment, reduced instillation, earlier efficacy, and best quality of life."
Laboratoires Théa was involved in all aspects of the study, including writing the report, and employs two of the authors.
SOURCE: https://bit.ly/1cIBop1