Health
Reducing unnecessary antibiotic use for conjunctivitis
Top line:
More than two-thirds of children with conjunctivitis received antibiotics within 1 day of their initial outpatient visit, but follow-up visits and new antibiotics were rare regardless of treatment, suggesting that lack of antibiotics may not translate into additional healthcare utilisation.
methodology:
- Researchers evaluated the frequency of topical antibiotic treatment and its association with subsequent healthcare utilization among privately insured children with acute infectious conjunctivitis in the United States.
- This cohort study analyzed data from the MarketScan Commercial Claims and Encounters Database for 2021, which included 44,793 children (median age 5 years, 47% girls) with conjunctivitis and outpatient care visits.
- The primary exposure was a topical antibiotic prescription filled within 1 day of the outpatient visit, with outcomes assessed 2–14 days after the visit.
- The primary outcome measures were outpatient care return visits for conjunctivitis and same-day administration of a new topical antibiotic, and secondary outcomes included emergency department return visits and hospitalizations.
remove:
- Topical antibiotics were prescribed within 1 day in 69% of outpatient visits, but less frequently after ophthalmology visits (34%), children aged 6–11 years (66%), and children after pediatric visits. Viral conjunctivitis (28%).
- Among children who received antibiotics, only 3.2% returned to the outpatient clinic within 2 weeks for conjunctivitis (adjusted odds ratio 0.011-0.025). [aOR]1.11; 95% CI, 0.99-1.25).
- Similarly, same-day visits with a new antibiotic prescription were uncommon (1.4%), and there was no significant association between antibiotic treatment and visits (aOR, 1.10; 95% CI, 0.92-1.33).
- Hospitalization for conjunctivitis occurred in 0.03% of cases, and return visits to the emergency department occurred in 0.12% of cases, with no difference between children who received antibiotics and those who did not.
in fact:
“Efforts to reduce overtreatment of acute infectious conjunctivitis are warranted, given that antibiotics may not be associated with improved outcomes or subsequent changes in healthcare utilization, and are associated with side effects and antibiotic resistance,” the authors write.
sauce:
The study was led by Daniel J. Shapiro, MD, MPH, of the University of California, San Francisco Department of Emergency Medicine. Publish online June 27, 2024, JAMA Ophthalmology.
Limitations:
The main limitations of this study include the inability to distinguish between scheduled and unscheduled return visits, incomplete clinical data, such as rare complications of conjunctivitis, and the inability to confirm the accuracy of the coded diagnosis of infectious conjunctivitis, especially in children who did not undergo a thorough ophthalmic examination.
Disclosure:
The authors declare that this study has not received funding from any source. One of the authors reports receiving grant funding from multiple sources outside the submitted work.
This article was created using multiple editorial tools, including AI as part of the process; a human editor reviewed this content before publishing.
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Sources 2/ https://www.medscape.com/viewarticle/cutting-down-unnecessary-antibiotics-pink-eye-2024a1000c5p The mention sources can contact us to remove/changing this article |
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