Clinical and laboratory validation and experience of picloxydine use in the treatment of neonatal dacryocystitis

Abstract

Purpose: to improve the clinical and functional results of the treatment of dacryocystitis of newborns (DN) and to validate local antibiotic therapy of children with DN in laboratory conditions. Materials and methods. The study involved two groups of children with DN. Group 1 (275 eyes) consisted of children treated as outpatients without taking account of the microbial spectrum of pathogens and their sensitivity to antibiotics. They had been prescribed the following medications: tobramycin (70.0 %), chloramphenicol (31.3 %) and tetracycline (17.2 %). Group 2 (118 eyes) consisted of children who received treatment based on the microbial spectrum of pathogens and their sensitivity to antibiotics. In this case, the treatment included picloxydine (Vitabact). In both groups, the children’s age was similar: 3.12 ± 0.18 months and 3.63 ±0.19 months, respectively (р > 0.05). Results. The microbial spectrum of DN pathogens is represented by 24 species of microorganisms and microbial associations (5.6 %). The major pathogens were: S. epidermidis (27.6 %), S. aureus (19.3 %) and S. pneumonia (8.0 %). The best sensitivity (94.1 %) was revealed to picloxydine (Vitabact). The treatment resulted in the recovery without probing the lacrimal tract in 6.1 % of group 1 patients and in 31.8 % of group 2 patients. Relapses requiring a re-probing of the lacrimal tract affected 12.3 % in group 1 and no patients in group 2. Conclusion. A two-stage DN treatment plan was developed and tested using etiologically validated antibacterial medications. The treatment resulted in the recovery of 31.8 % of children without probing the lacrimal tract, and prevention of DN relapses requiring re-probing // Russian Ophthalmological Journal, 2017; 1: 69-72. doi: 10.21516/2072-0076-2017-10-1-69-72.