Appropriateness of Antibiotic Prescribing for Acute Conjunctivitis: A Cross-Sectional Study at a Specialist Eye Hospital in Ghana, 2021

Abstract

Most presentations of conjunctivitis are acute. Studies show that uncomplicated cases resolve within 14 days without medication. However, antibiotic prescription remains standard practice. With antimicrobial resistance becoming a public health concern, we undertook this study to assess antibiotic prescription patterns in managing acute conjunctivitis in an eye hospital in Ghana. We recorded 3708 conjunctivitis cases; 201 were entered as acute conjunctivitis in the electronic medical records (January to December 2021). Of these, 44% were males, 56% were females, 39% were under 5 years, 21% were children and adolescents (5–17 years) and 40% were adults (≥18 years). A total of 111 (55.2%) patients received antibiotics, of which 71.2% were appropriately prescribed. The use of antibiotics was more frequent in children under 17 years compared to adults (p < 0.0001). Of the prescribed antibiotics, 44% belonged to the AWaRe “Access” category (Gentamycin, Tetracycline ointment), while 56% received antibiotics in the “Watch” category (Ciprofloxacin, Tobramycin). Although most of the antibiotic prescribing were appropriate, the preponderance of use of the Watch category warrants stewardship to encompass topical antibiotics. The rational use of topical antibiotics in managing acute conjunctivitis will help prevent antimicrobial resistance, ensure effective health care delivery, and contain costs for patients and the health system.

Ocular Chloramphenicol Exposure in Early Childhood in Aotearoa/New Zealand

“…limiting and serious complications are rare [2,3]. Antimicrobials are also used inappropriately in non-bacterial cases of conjunctivitis [6].…”

“…This study found that utilisation was prevalent among NZ children and began early in life. Though indications were not captured in the dataset used (which was a limitation of this analysis), it is possible that the high usage of chloramphenicol partially reflects its inappropriate use in non-infectious (such as allergic) and viral conjunctivitis, both highly prevalent conditions [5,6]. Although evidence of substantial clinical benefit is limited, topical antimicrobials are often prescribed in the management of acute bacterial conjunctivitis [2,3], which likely also contributes to the high usage of chloramphenicol.…”

“…However, evidence supporting usage of topical antimicrobials in acute bacterial conjunctivitis is limited, as most cases are self-limiting and serious complications are rare [2,3]. Antimicrobials are also used inappropriately in non-bacterial cases of conjunctivitis [6].…”

Differential Diagnostic Indicators for the Appointment of Non-Steroidal Anti-Inflammatory Therapy in the Treatment of Red Eye Syndrome at the Stage of Primary Outpatient Admission. Part 2

“…Как показали различные исследования, нередко воспалительный процесс при конъюнктивите не требует проведения медикаментозной терапии, особенно при отсутствии выраженной клинической симптоматики, так как воспаление купируется самопроизвольно [14,15]. Кроме того, рациональное использование местных антибиотиков при лечении острого конъюнктивита поможет предотвратить устойчивость к противомикробным препаратам, а также обеспечит эффективное оказание медицинской помощи и снизит расходы для пациентов и системы здравоохранения [16]. Важно дифференцировать степень выраженности воспалительного процесса при назначении лекарственных средств, особенно в условиях повышения резистентности к антибактериальным препаратам, а также большого количества осложнений, связанных с применением стероидной противовоспалительной терапии и повышенного уровня развития аллергических реакций на лекарственные препараты [17,18].…”

Broad-Spectrum Antimicrobial Activity of Oftasecur and Visuprime Ophthalmic Solutions

“…This disease can be classified according to chronicity, the seriousness of the disorder, the implication of affected tissues, and etiology [ 5 ]. Regarding chronicity, conjunctivitis can be classified as acute, lasting up to four weeks, and chronic, with a duration of more than four weeks [ 6 ].…”