ro13-9904 and Conjunctivitis

Clinicians in the authors' primary care academic practice have anecdotally perceived an increased use of intramuscular (IM) ceftriaxone, particularly for otitis-conjunctivitis in recent years (pre-pandemic). Increasing rates of ceftriaxone administration for acute otitis media (AOM) may be an important marker of antimicrobial resistance.. We aimed to characterize the population of patients who received ceftriaxone for treatment of AOM, testing our hypothesis that patients with concomitant conjunctivitis would have increased rates of ceftriaxone receipt.. We reviewed cases of AOM at a large U.S. primary care practice from August 2017 to July 2019. We determined the association between each of the following variables and ceftriaxone injection using multivariate analysis: age at AOM diagnosis, provider type, insurance (public vs private), season of year, and presence of conjunctivitis.. There were 6028 AOM episodes in 5195 patients resulting in a total of 7688 patient encounters. Of these episodes, 642 (10.7%) had a concurrent diagnosis of conjunctivitis; 362 (6.0%) ultimately received ceftriaxone. Conjunctivitis was the strongest predictor of treatment with ceftriaxone. The proportion of episodes with conjunctivitis treated with ceftriaxone was 14.5% (93/642) versus 5.0% (269/5386) without conjunctivitis (p < 0.0001). Patients who received ceftriaxone were younger; mean age (SD) for patients receiving ceftriaxone was 14.0 (8.8) months versus 25.0 (23.4) months (p < 0.0001).. There is a strong correlation between the presence of conjunctivitis and receipt of IM ceftriaxone in this large U.S. academic primary care clinic. Younger age was also associated with ceftriaxone treatment. Further study on emerging resistance patterns and implications for management of AOM in young children is warranted.

Topics: Acute Disease; Anti-Bacterial Agents; Ceftriaxone; Child; Child, Preschool; Conjunctivitis; Humans; Infant; Otitis Media; Primary Health Care

By culturing for N gonorrhoeae in cases of neonates and children with conjunctivitis, vaginitis, urethritis, proctitis, sepsis, and arthritis, gonococcal infections can be identified easily. They are then treated with ceftriaxone. In neonates, the mother and her sexual contacts also should be treated. In children, a full evaluation for sexual contacts, with the assistance of other professionals, if necessary, will almost always identify a sexual contact. Appropriate action then can be taken to protect the child from further sexual contact. .

Topics: Abscess; Ceftriaxone; Child; Child, Preschool; Conjunctivitis; Female; Gonorrhea; Humans; Infant; Infant, Newborn; Male; Mouth Diseases; Ophthalmia Neonatorum; Pelvic Inflammatory Disease; Pharyngeal Diseases; Proctitis; Scalp Dermatoses; Urethritis; Vaginitis

A 20-year-old man presented with bilateral ocular discharge and conjunctival injection. An ocular culture revealed Neisseria gonorrhoeae with decreased susceptibility to multiple drugs, including ceftriaxone. The patient was successfully treated with doxycycline (100 mg), which was administered orally, twice a day, for 7 days.

Topics: Anti-Bacterial Agents; Ceftriaxone; Conjunctivitis; Doxycycline; Drug Resistance, Bacterial; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Young Adult

Topics: Abdominal Pain; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antibodies, Monoclonal; Cardiomyopathy, Dilated; Ceftriaxone; Child; Clindamycin; Conjunctivitis; Diagnosis, Differential; Fever; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Infliximab; Jaundice; Male; Methylprednisolone; Mucocutaneous Lymph Node Syndrome; Nafcillin; Shock, Septic; Sodium Chloride; Treatment Outcome

Topics: Analgesics; Anti-Bacterial Agents; Azithromycin; Balanitis; Ceftriaxone; Child; Combined Modality Therapy; Conjunctivitis; Diagnosis, Differential; Drug Therapy, Combination; Germany; Hemagglutination Tests; Humans; Male; Parenteral Nutrition, Total; Pneumonia, Mycoplasma; Stomatitis

Topics: Adolescent; Ceftriaxone; Conjunctivitis; Doxycycline; Drug Therapy, Combination; Fever; Follow-Up Studies; Francisella tularensis; Humans; Insect Bites and Stings; Lymphadenitis; Male; Tularemia