A single-blinded randomized clinical trial comparing polymyxin B-trimethoprim and moxifloxacin for treatment of acute conjunctivitis in children

Lee Williams, Yogangi Malhotra, Barbra Murante, Susan Laverty, Steve Cook, David Topa, Dwight Hardy, Hongyue Wang, Francis Gigliotti

Research output: Contribution to journalArticle

6 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)857-861
Number of pages5
JournalJournal of Pediatrics
Volume162
Issue number4
DOIs
StatePublished - Apr 2013
Externally publishedYes

Fingerprint

Polymyxin B
Trimethoprim
Conjunctivitis
Randomized Controlled Trials
Therapeutics
Moraxella (Branhamella) catarrhalis
moxifloxacin
Cost Savings
Ophthalmic Solutions
Conjunctiva
Fluoroquinolones
Haemophilus influenzae
Streptococcus pneumoniae
Parents

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

A single-blinded randomized clinical trial comparing polymyxin B-trimethoprim and moxifloxacin for treatment of acute conjunctivitis in children. / Williams, Lee; Malhotra, Yogangi; Murante, Barbra; Laverty, Susan; Cook, Steve; Topa, David; Hardy, Dwight; Wang, Hongyue; Gigliotti, Francis.

In: Journal of Pediatrics, Vol. 162, No. 4, 04.2013, p. 857-861.

Research output: Contribution to journalArticle

Williams, L, Malhotra, Y, Murante, B, Laverty, S, Cook, S, Topa, D, Hardy, D, Wang, H & Gigliotti, F 2013, 'A single-blinded randomized clinical trial comparing polymyxin B-trimethoprim and moxifloxacin for treatment of acute conjunctivitis in children', Journal of Pediatrics, vol. 162, no. 4, pp. 857-861. https://doi.org/10.1016/j.jpeds.2012.09.013
Williams, Lee ; Malhotra, Yogangi ; Murante, Barbra ; Laverty, Susan ; Cook, Steve ; Topa, David ; Hardy, Dwight ; Wang, Hongyue ; Gigliotti, Francis. / A single-blinded randomized clinical trial comparing polymyxin B-trimethoprim and moxifloxacin for treatment of acute conjunctivitis in children. In: Journal of Pediatrics. 2013 ; Vol. 162, No. 4. pp. 857-861.
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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.",
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AU - Murante, Barbra

AU - Laverty, Susan

AU - Cook, Steve

AU - Topa, David

AU - Hardy, Dwight

AU - Wang, Hongyue

AU - Gigliotti, Francis

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