Trial reportBMJ (Clinical research ed.)2006
A randomised controlled trial of management strategies for acute infective conjunctivitis in general practice.
Trial report in BMJ (Clinical research ed.), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 40 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 10 syntheses or guidelines pooled it, 129 citations in OpenAlex.
- Immediate versus delayed versus no antibiotics for respiratory infections.The Cochrane database of systematic reviews · 2023Pooled it
- Antibiotics versus placebo for acute bacterial conjunctivitis.The Cochrane database of systematic reviews · 2023Pooled it
- A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Guideline
- Delayed antibiotic prescriptions for respiratory infections.The Cochrane database of systematic reviews · 2017Pooled it
- Written information for patients (or parents of child patients) to reduce the use of antibiotics for acute upper respiratory tract infections in primary care.The Cochrane database of systematic reviews · 2016Pooled it
- Patient information leaflets to reduce antibiotic use and reconsultation rates in general practice: a systematic review.BMJ open · 2015Pooled it
- A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2013 recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)(a).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2013Guideline
- Bacterial conjunctivitis.BMJ clinical evidence · 2012Pooled it
- Acute infective conjunctivitis in primary care: who needs antibiotics? An individual patient data meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Pooled it
- Bacterial conjunctivitis.BMJ clinical evidence · 2010Pooled it
- Trial
- Article
- Public preferences for delayed or immediate antibiotic prescriptions in UK primary care: A choice experiment.PLoS medicine · 2021Article
- Practical Guidance for Clinical Microbiology Laboratories: Diagnosis of Ocular Infections.Clinical microbiology reviews · 2021Review
- Low prevalence of Moraxella catarrhalis in the patients who suffered from conjunctivitis in the southwest of Iran.BMC research notes · 2020Article
- Delayed Antibiotic Prescription by General Practitioners in the UK: A Stated-Choice Study.Antibiotics (Basel, Switzerland) · 2020Article
- Clustering of continuous and binary outcomes at the general practice level in individually randomised studies in primary care - a review of 10 years of primary care trials.BMC medical research methodology · 2020Review
- A Review of the Differential Diagnosis of Acute Infectious Conjunctivitis: Implications for Treatment and Management.Clinical ophthalmology (Auckland, N.Z.) · 2020Review
- Use of delayed antibiotic prescription in primary care: a cross-sectional study.BMC family practice · 2019Article
- Toxic epidermal necrolysis: the red eye and red herrings in casualty.BMJ case reports · 2018Article
Corrections and comments
- Commented on by
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- Erratum issued
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo assess different management strategies for acute infective conjunctivitis.
designOpen, factorial, randomised controlled trial.
setting30 general practices in southern England.
participants307 adults and children with acute infective conjunctivitis.
interventionOne of three antibiotic prescribing strategies-immediate antibiotics (chloramphenicol eye drops; n = 104), no antibiotics (controls; n = 94), or delayed antibiotics (n = 109); a patient information leaflet or not; and an eye swab or not.
main outcome measuresSeverity of symptoms on days 1-3 after consultation, duration of symptoms, and belief in the effectiveness of antibiotics for eye infections.
resultsPrescribing strategies did not affect the severity of symptoms but duration of moderate symptoms was less with antibiotics: no antibiotics (controls) 4.8 days, immediate antibiotics 3.3 days (risk ratio 0.7, 95% confidence interval 0.6 to 0.8), delayed antibiotics 3.9 days (0.8, 0.7 to 0.9). Compared with no initial offer of antibiotics, antibiotic use was higher in the immediate antibiotic group: controls 30%, immediate antibiotics 99% (odds ratio 185.4, 23.9 to 1439.2), delayed antibiotics 53% (2.9, 1.4 to 5.7), as was belief in the effectiveness of antibiotics: controls 47%, immediate antibiotics 67% (odds ratio 2.4, 1.1 to 5.0), delayed antibiotics 55% (1.4, 0.7 to 3.0), and intention to reattend for eye infections: controls 40%, immediate antibiotics 68% (3.2, 1.6 to 6.4), delayed antibiotics 41% (1.0, 0.5 to 2.0). A patient information leaflet or eye swab had no effect on the main outcomes. Reattendance within two weeks was less in the delayed compared with immediate antibiotic group: 0.3 (0.1 to 1.0) v 0.7 (0.3 to 1.6).
conclusionsDelayed prescribing of antibiotics is probably the most appropriate strategy for managing acute conjunctivitis in primary care. It reduces antibiotic use, shows no evidence of medicalisation, provides similar duration and severity of symptoms to immediate prescribing, and reduces reattendance for eye infections.
trial registrationCurrent Controlled Trials ISRCTN32956955 [controlled-trials.com].
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.