title: A single-blinded randomized clinical trial comparing polymyxin B-trimethoprim and moxifloxacin for treatment of acute conjunctivitis in children.
abstract: OBJECTIVE
  To perform a randomized controlled trial comparing moxifloxacin hydrochloride with polymyxin B-trimethoprim for the treatment of acute conjunctivitis.
  
  
  METHODS
  Patients ages 1-18 years old with acute conjunctivitis had cultures performed and were randomized to receive either moxifloxacin hydrochloride or polymyxin B-trimethoprim ophthalmic solution for 7 days. Response to treatment was determined by phone query on day 4-6 and by examination with post-treatment conjunctival culture on day 7-10.
  
  
  RESULTS
  One hundred and twenty-four patients were enrolled. Eighty patients (65%) had recognized pathogens (55 Haemophilus influenzae, 22 Streptococcus pneumoniae, 4 Moraxella catarrhalis) isolated from their conjunctiva. One hundred fourteen (56/62 moxifloxacin and 58/62 polymyxin B-trimethoprim) completed the 4-6 day evaluation, with 43/56 (77%) of the moxifloxacin group and 42/58 (72%) of the polymyxin B-trimethoprim group clinically cured according to parents (noninferiority test P = .04). Eighty-nine (39/56 moxifloxacin and 50/58 polymyxin B-trimethoprim) patients completed the 7-10 day evaluation. Clinical cure was observed in 37/39 (95%) of the moxifloxacin and 49/51 (96%) of the polymyxin B-trimethoprim treated groups (noninferiority test P ≤ .01). Clinical cure rates for culture positive and negative conjunctivitis were not different. There was no statistically significant difference in bacteriologic cure rates between the 2 groups.
  
  
  CONCLUSIONS
  Polymyxin B-trimethoprim continues to be an effective treatment for acute conjunctivitis with a clinical response rate that does not differ from moxifloxacin. Use of polymyxin B-trimethoprim for the treatment of conjunctivitis would result in significant cost savings compared with fluoroquinolones.
authors.affiliation: Department of Pediatrics, Golisano Children's Hospital at Strong, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Williams
authors.forename: Yogangi
authors.initials: Y
authors.lastname: Malhotra
authors.forename: Barbra
authors.initials: B
authors.lastname: Murante
authors.forename: Susan
authors.initials: S
authors.lastname: Laverty
authors.forename: Steve
authors.initials: S
authors.lastname: Cook
authors.forename: David
authors.initials: D
authors.lastname: Topa
authors.forename: Dwight
authors.initials: D
authors.lastname: Hardy
authors.forename: Hongyue
authors.initials: H
authors.lastname: Wang
authors.forename: Francis
authors.initials: F
authors.lastname: Gigliotti
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001372:Aza Compounds / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003228:Conjunctiva / Q000382:microbiology; D003234:Conjunctivitis, Bacterial / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D024841:Fluoroquinolones; D006193:Haemophilus influenzae / Q000378:metabolism; D006801:Humans; D007223:Infant; D008297:Male; D001936:Moraxella catarrhalis / Q000378:metabolism; D000077266:Moxifloxacin; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D011112:Polymyxin B / Q000627:therapeutic use*; D011804:Quinolines / Q000627:therapeutic use*; D016037:Single-Blind Method; D013296:Streptococcus pneumoniae / Q000378:metabolism; D014295:Trimethoprim / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D009883:Ophthalmic Solutions; D011804:Quinolines; D014295:Trimethoprim; D011112:Polymyxin B; D000077266:Moxifloxacin