A study recently published in JAMA Ophthalmology investigated the prevalence of antibiotic use in infectious conjunctivitis and the association of antibiotic treatment in different healthcare settings.
Give me some background first.
Acute infectious conjunctivitis is one of the most common pediatric ocular conditions. Per the American Academy of Ophthalmology, while foregoing immediate topical antibiotic treatment is safe in most cases, antibiotics are often prescribed.
Thus: Researchers here investigated the frequency of antibiotic use in pediatric conjunctivitis along with subsequent healthcare use in the United States.
Now, talk about the study.
Participants were included from a nationwide MarketScan database of insurance claims from 2021. Cases included were focused on patients aged 1-17 years of age with a diagnosis of conjunctivitis.
A total of 44,793 ambulatory care encounters were utilized for analysis. Female participants made up 47% of the study population while males made up 53%; the median age was 5 years old.
Findings?
After multivariable analysis, researchers found that in 69% of cases, topical antibiotics were dispensed within one day of the encounter.
Further, physicians’ offices prescribed antibiotics to 72% of patients, compared to emergency rooms (ie: ambulatory care) at 57% and eye clinics at 34%.
What about subsequent health care use?
Researchers found that revisits to ambulatory care after 14 days occurred in 3.2% of encounters, and all-cause revisits with a same-day antibiotic dispensation were found after 1.4% of encounters.
Following analysis, it was identified that topical antibiotic treatment was not associated with:
- Ambulatory care revisits for conjunctivitis
- Revisits with same-day topical antibiotic dispensation
Go on…
There was no difference across exposure groups in both conjunctivitis-related hospitalizations and emergency department revisits, suggesting that there were no higher risks without prescriptions.
Expert opinion?
Per the authors of the study: “Children who were initially evaluated in eye clinics were infrequently treated with topical antibiotics but had more frequent ambulatory care revisits when antibiotics were dispensed.”
They suggested that this displays “a higher threshold for treatment and closer follow-up care for presumed bacterial conjunctivitis.”
Take home.
This study found a high frequency of antibiotic prescriptions in pediatric infectious conjunctivitis as well as critical insights into subsequent healthcare visit prevalence.
The study authors concluded: “Given that antibiotics may not be associated with improved outcomes or changes in subsequent health care use and are associated with adverse effects and antibiotic resistance, efforts to reduce overtreatment of acute infectious conjunctivitis are warranted.”