|Year : 1982 | Volume
| Issue : 3 | Page : 125-127
Treatment of acute infective conjunctivitis with oxytetracycline ointment
Dhanwant Singh, Bipin Beri
Department of Ophthalmology, Medical College, Patiala, India
Professor & Head of Eye Deptt. Government Medical College, Patiala
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh D, Beri B. Treatment of acute infective conjunctivitis with oxytetracycline ointment. Indian J Ophthalmol 1982;30:125-7
|How to cite this URL:|
Singh D, Beri B. Treatment of acute infective conjunctivitis with oxytetracycline ointment. Indian J Ophthalmol [serial online] 1982 [cited 2020 Apr 4];30:125-7. Available from: http://www.ijo.in/text.asp?1982/30/3/125/28189
The efficacy of antibiotics needs to be periodically re-evaluated because the susceptibility of bacteria to them is likely to change over years. Since oxytetracycline has been in clinical use for over 25 years, we studied its effectiveness in acute infective conjunctivitis, the susceptibility of isolated pathogens to it, and the correlation between in vivo and in vitro results.
| Materials and methods|| |
Fifty outpatients with acute conjunctivitis were serially enrolled in the study. A bacteriological examination of the ocular discharge by Gram's staining confirmed infective conjunctivitis. Patients who had applied any anti-infective medication to the eye during the previous 2 days were excluded from the study.
The intensity of symptoms and signs such as redness, photophobia and discharge was noted on a four point scale, viz. O =absent, 1=mild, 2=moderate, 3 = severe. Keratitis and blepharitis, if present, were also noted. A swab of the ocular discharge was taken from the lower fornix for culture and antibiotic sensitivity test (AST) by the disc diffusion method using a 30 mcg disc of oxytetracycline.
A I % ointment of oxytetracycline (Terramycin, Pfizer) was used for the treatment. The patients were instructed to apply 1 cm of the ointment into the lower fornix 3 times a day. They were re-examined on the 2nd, 5th and 8th days to assess the relief of symptoms and signs. These were graded from 0 to 3 as before. On the 8th day a swab was again taken from the lower fornix to ascertain eradication of the pathogen.
| Observations|| |
All 50 patients completed the study. Of the patients, 32 were males and 18 were females. Their ages ranged from 4 to 80 years with a mean of 25.6 years. The diagnosis was acute mucopurulent conjunctivitis in all cases. It was associated with blepharitis in 37 patients, keratitis in 20 patients, and infected chalazion in one patient.
The organisms isolated were coagulase positive staphylococci in 47 cases (94%), Kl. pneumoniae in 2 cases (4%), and St. haemolyticus in one case (2%). Their sensitivity to oxytetracycline is shown in [Table - 1]. Of the 47 staphylococci, 36 (77%) were sensitive or moderately sensitive to the drug.
Clinically, 46 patients (92%) were cured with complete or almost complete relief of symptoms and signs and eradication of the pathogen [Table - 1]. As 10 patients were cured in spite of their pathogens being resistant according to the AST result, the correlation between clinical and in vitro bacteriological results were explored.
As shown in [Table - 2], one patient was not cured even though his pathogen was sensitive by the AST result. Thus the incidence of false sensitive AST results was 3% (1/37). On the contrary, 10 patients were cured although their pathogens were resistant by the AST result, so that the incidence of false resistant AST results was 77;0 (10/13).
[Table - 3] shows the mean symptom scores at the beginning of treatment and at subsequent follow-up examinations. Photophobia, lacrimation, redness and discharge subsided in that order by day 7, and considerable relief of symptoms was evident on day 4. Keratitis and blepharitis also subsided.
No adverse reactions, either local or general, were seen.
| Discussion|| |
A cure rate of 92% observed in this study reconfirms the efficacy of 1 % oxytetracycline ointment in acute mucopurulent conjunctivitis.
The pathogenic organism in most cases (94%) was coagulase positive staphylococcus. Nagar and Charan found these organisms in 31 of 50 patients (62%) with acute mucopurulent conjunctivitis. Easty has also stated that S. aureus is the most common cause of acute conjunctivitis.
The correlation between clinical results and AST results showed that the AST as performed gave an unacceptably high incidence of false resistant results (77%) and thus under estimated the true efficacy of oxytetracycline.
As compared with aminoglycosides such as framycetin, the tetracyclines are effective against a larger variety of ocular pathogens including N. gonorrhoeae and Ps. Aeruginosa. They are also effective against Chlamydia trachomatis which is highly prevalent in our country. Oxytetracycline ointment shares this advantage. Besides, the petrolatum base of the ointment prevented sticking of eye lids during sleep.
| Summary|| |
In 50 patients with acute mucopurulent conjunctivitis, the most common pathogen was coagulase positive staphylococcus (94%). A 1 % oxytetracycline ointment was effective clinically and bacteriologically in 92% of patients. Antibiotic sensitivity test by disc diffusion method gave a high incidence of false resistant results (10/13 or 77%) and underestimated the true efficacy of oxytetracycline.
| References|| |
Bauer, A.W., Kirby, W.M.M., Sherris, J.C. and Turck, M., 1966, Amer J, Clin : Pathol., 45 : 493.
Nagar, D.N., and Charan, H., 1965, J. Ind. Med Assoc., 45 :64.
Easty, D.L., 1980, Practitioner, 224: 593.
[Table - 1], [Table - 2], [Table - 3]