EC Ophthalmology

This paper studies the spectrum of pathogens and the antibacterial therapeutic results of using azithromycin 1.5% eye drops in pediatric bacterial conjunctivitis, dacryocystitis, and chalazion. Staphylococcus epidermidis and Staphylococcus aureus proved to be the most frequently occurring pathogens, with rates of 58.5% and 24.5%, respectively. Mixed infections were discovered in 61.7% of cases. During the first year of life in children with congenital dacryocystitis, Staphylococcus epidermidis was detected most frequently (40.9%), followed by Staphylococcus aureus and Staphylococcus haemolyticus, with rates of 22.7% and 9.0%, respectively. In chalazions and in bacterial conjunctivitis, Staphylococcus epidermidis was also the most frequent, with rates of 68.3% and 62.3%, while Staphylococcus aureus was less frequent and identified in 10.5%. and 30.2% of cases, respectively.

Azithromycin was found to have high efficacy (98.9%) despite the fact that pathogens’ sensitivity to it is not sufficiently high (45.7%). Azithromycin 1.5%, administered in a convenient dosage regimen of one drop twice daily for three days, leads to rapid resolution of the main signs of pediatric purulent eye diseases. This improved convenience makes it easier to follow the treatment regimen and reduces the burden of the disease on and parents.

 Keywords: Bacterial Conjunctivitis; Dacryocystitis; Chalazion; Pathogens; Azithromycin; Children

1. Cochereau I., et al. “3-day treatment with azithromycin 1.5% eye drops versus 7 day treatment with tobramycin 0.3% for purulent bacterial conjunctivitis: multicentre, randomised and controlled trial in adults and children”. British Journal of Ophthalmology 4 (2007): 465-469.
2. Haque RM., et al. “Multicenter open-label study evaluating the efficacy of azithromycin ophthalmic solution 1% on the signs and symptoms of subjects with blepharitis”. Cornea8 (2010): 871-877.
3. Alemu BM and Worku T. “Efficacy of azithromycin 1% and 1.5% ophthalmic solutions compared to tobramycin 0.3% eye drops: A systematic review and meta-analysis”. SAGE Open Medicine 8 (2020): 2050312120958846.
4. Arita Reiko and Fukuoka Shima. “Efficacy of azithromycin eyedrops for individuals with meibomian gland dysfunction-associated posterior blepharitis”. Eye and Contact Lens: Science and Clinical Practice1 (2021): 54-59.
5. Buznach N., et al. “Clinical and bacterial characteristics of acute bacterial conjunctivitis in children in the antibiotic resistance era”. Pediatric Infectious Disease Journal 9 (2005): 823-828.
6. Azari AA and Barney NP. “Conjunctivitis: a systematic review of diagnosis and treatment”. Journal of the American Medical Association16 (2013): 1721-1729.
7. Bremon-Ginac D., et al. “Efficacy and safety of azithromycin 1.5% eye drops in paediatric population with purulent bacterial conjunctivitis”. British Journal of Ophthalmology 6 (2014): 739-745.
8. Shirokobokov VP. “Medical microbiology and immunology 3^rd edition” (2021): 920.
9. Chen FV., et al. “Patient demographic and microbiology trends in bacterial conjunctivitis in children”. Journal of AAPOS 1 (2018): 66-67.
10. Bobrova NF and Molodaya AL. “Microflora in conjunctivitis and dacryocystities in newborns and its sensitivity to antibacterial drugs”. Oftalmologicheskiĭ Zhurnal 6 (2011): 4-8.
11. Blondeau JM., et al. “Characterization of polybacterial versus monobacterial conjunctivitis infections in pediatric subjects across multiple studies and microbiological outcomes with besifloxacin ophthalmic suspension 0.6%”. Clinical Ophthalmology 15 (2021): 4419-4430.
12. Drago L. “Chloramphenicol resurrected: A journey from antibiotic resistance in eye infections to biofilm and ocular microbiota”. Microorganisms9 (2019): 278.
13. Peters DH., et al. “Azithromycin: a review of its antimicrobial activity, pharmacokinetic properties and clinical efficacy”. Drugs5 (1992): 750-799.
14. Dunn CJ and Barradell LB. “Azithromycin: a review of its pharmacological properties and use as 3-day therapy in respiratory tract infections”. Drugs3 (1996): 483-505.
15. Bremond-Gignac D., et al. “A 3-day regimen with azithromycin 1.5% eyedrops for the treatment of purulent bacterial conjunctivitis in children: efficacy on clinical signs and impact on the burden of illness”. Clinical Ophthalmology 9 (2015): 725-732.
16. Asbell PA and DeCory HH. “Antibiotic resistance among bacterial conjunctival pathogens collected in the antibiotic resistance monitoring in ocular microorganisms (ARMOR) surveillance study”. PLoS One10 (2018): e0205814.