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felix Victor chen, Kara Marie Cavuoto; Patient demographic and microbiology trends in pediatric conjunctivitis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2427.
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© ARVO (1962-2015); The Authors (2016-present)
Conjunctivitis is one of the most prevalent conditions in pediatric ophthalmology. Although typically a self-limiting condition, conjunctivitis has a significant economic impact in lost school days, clinic visits, and medications. This retrospective study reports patient demographics and microbiology trends for children presenting with bacterial conjunctivitis in South Florida over a 5 year span.
We reviewed medical records of all patients under 18 years old diagnosed with conjunctivitis from January 1, 2010 through December 30, 2015. Data on age, gender, culture results, and in vitro susceptibility were collected. In vitro susceptibility data were generated using disc diffusion and minimal inhibitory concentrations.
Of the 3192 children diagnosed with conjunctivitis, 40% were viral, 10% bacterial, 7% vernal/allergic, and the remaining 43% unspecified. More than half of children were younger than 6 years (53%). The majority of patients (86%) were seen in an outpatient setting. Only 12% had a culture performed. Of the 391 cultures, 173 were positive which yielded 202 bacterial isolates. The majority of isolates were gram-negative (57%, 115/202). Patients age 0-6 were more likely to be affected by gram-negative bacteria than children 6-18 (62% vs 40%, p=0.0084). H. influenzae was the most common organism from ages 0-6 (33%, 52/160), but S. aureus was the primary organism in ages 6-18 (43%, 18/42).62% (1968/3192) of all conjunctivitis cases were treated with antibiotics. Primary care centers prescribed antibiotics more frequently (73%) than ophthalmology-specific facilities (32%). The most commonly prescribed antibiotics were ofloxacin (34%, 674/1968), polymyxin/trimethoprim sulfate (23%, 449/1968), and tobramycin (11%, 221/1968), however erythromycin was the most common treatment for children 0-1 (36%, 117/321). Overall, there was low resistance to fluoroquinolones (2%, 4/140) as compared to the nearly one-third of organisms that were resistant to erythromycin (31%, 19/61).
Bacterial conjunctivitis constituted only 10% of pediatric conjunctivitis cases in our study, despite treatment with antibiotics in over half of the cases. Primary care providers are more like to dispense antibiotics than ophthalmologists. H. influenzae was the most common organism, but its prevalence differs with age. Resistance profiles demonstrate the highest sensitivity to fluoroquinolones.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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