A new randomised clinical trial and meta-analysis confirms that topical antibiotics significantly shorten the duration of acute infective conjunctivitis in children.

The trial also suggests that “lubricating eye drops may have some benefits for the management of acute infective conjunctivitis in children”.

The randomised clinical trial included 30 children (mean age 2.8 years) who received one moxifloxacin drop in each affected eye three times a day for up to seven days, 27 children (mean age 3.0 years) who received carboxymethylcellulose placebo eye drops and 31 children (mean age 3.2 years) who received no intervention at all. 

The time to clinical cure was significantly shorter with moxifloxacin than no intervention (3.8 and 5.7 days respectively). No significant difference emerged in the time to clinical cure between the placebo group (4.0 days) and either moxifloxacin or no intervention, or in the relapse rate within 14 days across the three groups.

In a meta-analysis of three previous studies and this trial, 300 children received topical antibiotics and 284 received placebo. Topical antibiotics reduced the proportion with conjunctivitis symptoms by 41 per cent on days three to six and by 47 per cent on days seven to 10 compared with placebo.

Topical antibiotics significantly reduced the proportion with positive bacterial conjunctival culture on days seven to 10 by 66 per cent compared with placebo. (JAMA Network Open 2022; 5:e2234459)