A controlled trial of povidone-iodine to treat infectiou conjunctiviti in children

PURPOE: To report the efficacy of povidone-iodine a a treatment for conjunctiviti in pediatric patient. DEIGN: Double-maked, controlled, propective clinical trial. METHOD: In an ophthalmology clinic in a general hopital in Manila, Philippine, 459 children (mean [D] age 6.6 [6.6] year; range, 7 month-21 year) with acute conjunctiviti were tudied. Infected eye were cultured for bacteria and underwent immunofluorecent teting for Chlamydia trachomati. Viral conjunctiviti wa diagnoed if bacterial culture were negative and diagnotic criteria were met. ubject were alternated to receive povidone-iodine 1.25% or neomycin-polymyxin-B-gramicidin ophthalmic olution, one drop 4 time daily in the affected eye. Ocular inflammation wa evaluated daily by the family or patient and weekly by an ophthalmologit. The main outcome meaure were day until cured and proportion cured after 1 and 2 week of treatment. REULT: Depite adequate tatitical power (power >80% for a 1-day difference and P < .05), there wa no ignificant difference between treatment group regarding the number of day to cure or proportion cured at 1 or 2 week whether caued by bacteria or viru (P = .133–.824 for the four comparion). After 1 week of treatment, povidone-iodine cured marginally more chlamydial infection than the antibiotic (P = .057). By 2 week, fewer chlamydial infection were cured than thoe of viral or bacterial etiology (P = .0001). The younger the patient, the fater their conjunctiviti reolved (R = 0.13, P = .013). CONCLUION: Povidone-iodine 1.25% ophthalmic olution wa a effective a neomycin-polymyxin B-gramicidin for treating bacterial conjunctiviti, omewhat more effective againt chlamydia, and a ineffective againt viral conjunctiviti. Povidone-iodine ophthalmic olution hould be trongly conidered a treatment for bacterial and chlamydial conjunctiviti, epecially in developing countrie where topical antibiotic are often unavailable or cotly.