Revisión sistemática
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Estudio primario
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A study was conducted to determine the safety and efficacy of topically applied ciprofloxacin ophthalmic solution in a pediatric population experiencing acute bacterial conjunctivitis. Topically applied ciprofloxacin (3 mg/mL) is known to be a safe and effective treatment for adults suffering from bacterial conjunctivitis; however, the safety and effectiveness of this broad-spectrum fluoroquinolone in pediatric patients is not well established. Ciprofloxacin was evaluated in a double-blind, randomized, controlled study of 257 patients ranging from 0 (i.e., less than 1 year) to 12 years of age from 33 geographically diverse medical centers. The children received either 0.3% ciprofloxacin ophthalmic solution (Ciloxan, Alcon Laboratories, Fort Worth, TX) or tobramycin ophthalmic solution (Tobrex, Alcon Laboratories, Fort Worth, TX). Both test medications were administered topically every 2 hours on days 1 and 2 followed by every 4 hours on days 3 through 7. Eyes were cultured prior to enrollment and again on day 7. Treatment efficacy as determined by microbiological culture data and physicians' judgment of overall resolution was similar for the ciprofloxacin and tobramycin groups. Microbiological eradication was observed in 90.1% of the ciprofloxacin group and 84.3% of the tobramycin group (P = 0.29). Physicians judged 87.0% of the ciprofloxacin patients and 89.9% of the tobramycin patients clinically cured on day 7 (P > 0.5). There were no serious adverse medical events attributable to either treatment. This study showed that topically applied ciprofloxacin ophthalmic solution is safe and effective in a pediatric population experiencing acute bacterial conjunctivitis.
Estudio primario
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Objetivo: Comparar los resultados de los tratamientos homeopático y convencional sobre la epidemia de conjuntivitis viral del año 1997 en Ranchuelo, VC, Cuba. Material y métodos: Se trata de un estudio retrospectivo de un total de 67 pacientes que se diagnosticaron y se ingresaron durante la epidemia de conjuntivitis viral que se produjo en los meses de julio a septiembre de 1997 en el área de salud de Ranchuelo, conformados en dos grupos, un primer grupo de 47 pacientes tratados con medicamentos convencionales y un segundo grupo de 20 pacientes tratados con medicamentos homeopáticos, Resultados: Se comprobó que el tratamiento homeopático produjo la curación en menor tiempo, necesitando el otro tratamiento casi el doble del tiempo y además, que el tratamiento homeopático demostró ser más barato que el convencional, siendo el costo de éste último más del doble. Conclusiones: Quedó demostrada la buena acción del medicamento homeopático sobre la epidemia, con la curación que se produjo en mucho menos tiempo y con menos costo que con los otros medicamentos.
Revisión sistemática
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Este artículo no tiene resumen
Estudio primario
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This study was carried out to assess the efficacy of 0.025% and 0.05% azelastine eye-drops in patients with seasonal allergic conjunctivitis of >1 year's duration. A total of 151 patients received 0.025% or 0.05% azelastine eye-drops or placebo b.i.d. for 14 days according to a double-blind, randomized, placebo-controlled, parallel-dosing design; 129 patients completed the study as planned. The three target symptoms, scored on 4-point scales, were itching, lacrimation, and redness of the eyes; responders were patients whose symptom sum score decreased by >3 from a baseline score of >6 by day 3. Mean scores of these and five other symptoms were recorded also on days 7 and 14, and patients kept daily diaries of the three main symptoms and swollen eyelids. Responder rates were 73% for 0.025% (p = 0.115 V.V placebo) and 82% for 0.05% azelastine eye-drops (P=0.011 vs placebo) and 56% for placebo. The time courses of the mean (investigators' and patients') scores for the three main symptoms reflected the dose-dependent effect of azelastine eye-drops. One patient each from the two azelastine groups and three from the placebo group withdrew because of ineffieacy. Adverse drug reactions were reported by 14 and 24 patients receiving 0.025% and 0.05% azelastine eye-drops, respectively, and by eight placebo patients. These reactions were mainly slight application site reactions and taste perversion (bitter or unpleasant taste). Azelastine eye-drops are effective and well tolerated at a dose of 0.05% for the treatment of seasonal allergic conjunctivitis.
Estudio primario
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Chlamydia has been found to be the cause of a high percentage of cases of neonatal and chronic conjunctivitis in an inner-city population. To assess the etiology and epidemiology of acute conjunctivitis in this population, conjunctival scrapings were sampled from 45 patients presenting to an ocular emergency room; and replicate chlamydial, viral, and bacterial cultures and cytology tests were done. No cases of chlamydial conjunctivitis were diagnosed, although a viral etiology was established in 36% of the cases and a bacterial etiology in 40%. Twenty-four percent of the cases were not diagnosed. The authors recommend limiting the initial laboratory workup of patients with acute conjunctivitis to obtaining conjunctival smears for Gram and Giemsa staining. Chlamydial direct immunofluorescent monoclonal antibody (DFA) should be done if the patient is sexually active. Hyperacute conjunctivitis or acute conjunctivitis refractory to treatment mandates a more complete set of laboratory tests.
Estudio primario
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Objetivo: Evaluar y comparar la eficacia y la tolerabilidad de uso tópico de fumarato de ketotifeno 0,05% de hidrocloruro de olopatadina 0,1% en el tratamiento de pacientes con conjuntivitis alérgica. Métodos: Se realizó enmascarado, estudio clínico aleatorizado que compara la eficacia , seguridad y efectos secundarios con el uso de la solución oftálmica de ketotifeno fumarato 0,05% de hidrocloruro de olopatadina 0,1% en el alivio de los signos y síntomas en pacientes con conjuntivitis alérgica. Treinta y cuatro pacientes que cumplan los criterios de inclusión del protocolo se les dio un frasco con la droga enmascarado, inculcar una gota dos veces al día en cada ojo durante 30 días. Los síntomas y signos de los pacientes fueron evaluados en una visita pre-tratamiento y cinco tratamiento (primero día, segundo día, 7 días, 14 días y 30 días). Resultados: La severidad de la conjuntivitis alérgica fue similar en ambos grupos de estudio. Tanto ketotifeno y olopatadina fueron equivalentes y eficaz en la disminución de los síntomas de picazón, ardor y lagrimeo. Los signos, hiperemia en conjuntiva bulbar fue atenuada en ambos grupos. Se observó Evaluación de las reacciones adversas en la quema de administración de ambos gotas para los ojos y la aparición de picor en el grupo de ketotifeno. No se observó ninguna reacción de hipersensibilidad a los fármacos estudiados. Conclusiones: Este estudio muestra que la solución oftálmica de ketotifeno fumarato 0,05% de hidrocloruro de olopatadina y 0,1% cuando se inculca dos veces al día durante 30 días, son eficaz y seguro en el alivio de los principales síntomas de la conjuntivitis alérgica.
Estudio primario
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Revisión sistemática
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Intranasal steroids provide better relief for adult sufferers, according to nonstandardized, nonclinically validated scales. Steroids reduce subjective total nasal symptom scores (TNSS)--representing sneezing, itching, congestion, and rhinorrhea--by about 25% more than placebo, whereas oral antihistamines decrease TNSS by 5% to 10% (strength of recommendation [SOR]: B, systematic review of randomized controlled trials [RCTs], most without clinically validated or standardized outcome measures). Intranasal steroids improve subjective eye symptom scores as well as (or better than) oral antihistamines in adults who also have allergic conjunctivitis (
Estudio primario
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We studied 102 children aged 1 month to 18 years in a randomized, double-blind trial designed to determine both the natural history of bacterial conjunctivitis and whether topical antibiotic therapy is beneficial. Affected eyes were treated four times a day for 7 days with drug (polymyxin-bacitracin ophthalmic ointment) or placebo. Eighty-four patients had proved bacterial conjunctivitis (Haemophilus influenzae 61, Streptococcus pneumoniae 22, both one); 66 of these received only topical therapy. By 3 to 5 days, 21 of 34 (62%) patients receiving topical antibiotic were clinically cured, whereas only nine of 32 (28%) patients given placebo were cured (P less than 0.02). By 8 to 10 days, 31 (91%) of the patients given antibiotic and 23 (72%) of the placebo group were cured (P = NS). The bacterial pathogen was eradicated by day 3 to 5 in 71% and by day 8 to 10 in 79% of patients given antibiotic, compared to 19% and 31% of the placebo group (P less than 0.001). Acute bacterial conjunctivitis is a self-limited disease, but topical antibiotic therapy with polymyxin-bacitracin shortens the duration of clinical disease and enhances eradication of the causative organism from the conjunctiva.