Treating with besifloxacin for acute bacterial conjunctivitis: a Meta-analysis

AIM: To evaluate the relative efficacy and safety of besifloxacin for treatment of acute bacterial conjunctivitis. METHODS: A comprehensive search in PubM ed, EMBASE Web of Science, Cochrane Central Database and CNKI was undertaken for randomized controlled trials(RCTs) comparing besifloxacin with other treatments or placebo. The primary outcome measures were clinical resolution, rates of bacterial eradication, individual clinical outcomes, cure rates, and bacterial eradication rates of different kinds of pathogens. Safety outcomes were the number of adverse effects(AEs). The final search was performed on August 2018. RESULTS: Six RCTs were included. Four studies compared the efficacy and safety of besifloxacin with placebo, 1 study compared besifloxacin with moxifloxacin, and 1 study compared besifloxacin with gatifloxacin. A total of 2780 patients met the inclusion criteria. Besifloxacin presented higher efficacy and safety than did placebo in clinical resolution, rates of bacterial eradication, individual clinical outcomes, cure rates, bacterial eradication rates of different kinds of pathogens and the number of AEs. There was no significant difference between besifloxacin and moxifloxacin or gatifloxacin in the comparison items mentioned above. CONCLUSION: Besifloxacin is highly effective and safe for treatment of acute bacterial conjunctivitis. Further comparative trials regarding the effect of besifloxacin for treatment of acute bacterial conjunctivitis will aid in treatment decisions.

Molecular analysis of Coxsackievirus A24 variant isolates from three outbreaks of acute hemorrhagic conjunctivitis in 1988,1994 and 2007 in Beijing,China

Coxsackievirus A24 variant(CVA24v)is a major pathogen that causes continued outbreaks and pandemics of acute hemorrhagic conjunctivitis(AHC).In China,the first confirmed outbreak of CVA24v-related AHC occurred in Beijing in 1988,followed by another two significant outbreaks respectively in 1994 and 2007,which coincides with the three-stage dynamic distribution of AHC in the world after 1970s.To illustrate the genetic characteristics of CVA24v in different periods,a total of 23 strains were isolated from those three outbreaks and the whole genome of those isolations were sequenced and analyzed.Compared with the prototype strain,the 23 strains shared four nucleotide deletions in the 5'UTR except the 0744 strain isolated in 2007.And at the 98th site,one nucleotide insertion was found in all the strains collected from 2007.From 1994 to 2007,amino acid polarity in the VP1 region at the 25th and the 32nd site were changed.Both the 3C and VP1 phylogenetic tree indicated that isolates from 1988 and 1994 belonged to Genotype III(GIII),and 2007 strains to Genotype IV(GIV).According to the Bayesian analysis based on complete genome sequence,the most recent common ancestors for the isolates in1988,1994 and 2007 were respectively estimated around October 1987,February 1993 and December 2004.The evolutionary rate of the CVA24v was estimated to be 7.45×10^(-3) substitutions/site/year.Our study indicated that the early epidemic of CVA24v in Chinese mainland was the GIII.Point mutations and amino acid changes in different genotypes of CVA24v may generate intensity differences of the AHC outbreak.CVA24v has been evolving constantly with a relatively rapid rate.