RT Journal
A1 Meltzer JA, Kunkov S, Crain EF
T1 IDentifying children at low risk for bacterial conjunctivitis
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2010
FD March 1
VO 164
IS 3
SP 263
OP 267
DO 10.1001/archpediatrics.2009.289
UL http://dx.doi.org/10.1001/archpediatrics.2009.289
AB 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 Outcome Measures 
    The χ2 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.