Identifying children at low risk for bacterial conjunctivitis.
Arch Pediatr Adolesc Med
; 164(3): 263-7, 2010 Mar.
Article
em En
| MEDLINE
| ID: mdl-20194260
ABSTRACT
OBJECTIVE:
To identify a population of children at low risk for bacterial conjunctivitis on the basis of history and physical examination findings.DESIGN:
Prospective observational cohort study.SETTING:
Urban pediatric emergency department.PARTICIPANTS:
Children aged 6 months to 17 years with conjunctival erythema, eye discharge, or both. The exclusion criteria were eye trauma, exposure to a noxious chemical, contact lens use, and antibiotic drug use in the past 5 days.INTERVENTIONS:
Clinicians completed a checklist of signs and symptoms and collected a conjunctival swab for bacterial culture. MAIN OUTCOMEMEASURES:
The chi(2) test, the Mann-Whitney test, and logistic regression were used to create a prediction model for a negative bacterial culture.RESULTS:
Of 368 patients enrolled, 194 (52.7%) were males. The median patient age was 3 years (interquartile range, 1-5 years). Conjunctival cultures were negative in 130 patients (35.3%). Age 6 years or older, presentation in April through November, no or watery discharge, and no glued eye in the morning were the clinical factors found to be independently associated with a negative conjunctival culture. If 3 factors were present, 76.4% (95% confidence interval, 63.6%-85.6%) of patients had a negative culture. If all 4 factors were present, 92.3% (95% confidence interval, 66.1%-98.2%) of patients had a negative culture.CONCLUSION:
The combination of 4 clinical factors may enable clinicians to identify children at low risk for bacterial conjunctivitis and may reduce routine antibiotic drug administration.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
3_ND
/
4_TD
Base de dados:
MEDLINE
Assunto principal:
Conjuntivite Bacteriana
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
/
Female
/
Humans
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Infant
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Arch Pediatr Adolesc Med
Ano de publicação:
2010
Tipo de documento:
Article