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Use of Topical Steroids in Conjunctivitis: A Review of the Evidence

机译：在结膜炎中使用局部类固醇：对证据的审查

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Purpose: Conjunctivitis, or inflammation of the conjunctiva, is a common condition that can be caused by infectious (eg, bacterial or viral infections) and noninfectious (eg, allergy) etiologies. Treatment involves diagnosis of the underlying cause and use of appropriate therapies. A broad-spectrum therapy that can address multiple etiologies, and also the accompanying inflammation, would be very useful. In this review, we discuss the usefulness of topical ophthalmic corticosteroids and ophthalmic formulations that combine corticosteroids with anti-infectives/antibiotics for treating acute infectious conjunctivitis. Methods: A review of the published literature and relevant treatment guidelines. Results: Topical corticosteroids are useful in treating ocular inflammation, but most treatment guidelines recommend steroid use generally in severe cases of conjunctivitis. This is partly due to risks associated with steroid use. These risks include potential for prolonging adenoviral infections and potentiating/worsening herpes simplex virus infections, increased intraocular pressure, glaucoma, and cataracts. Most of these perceived risks are not, however, supported by high-quality clinical data. They are also associated with long-term steroid uses that are dissimilar to applications for infectious conjunctivitis. Clinical data show that ophthalmic formulations that combine corticosteroids with broad-spectrum anti-infectives could be effective and -well tolerated when used for short-term treatment (<=2 weeks). Conclusions: Corticosteroids, in combination with anti-infectives, could be a promising treatment option for acute conjunctivitis subject to development of further evidence on their effectiveness and safety in conjunctivitis treatment.
机译：目的：结膜炎或结膜炎的炎症是一种常见的病症，可以是由传染病（例如，细菌或病毒感染）和非染色（例如，过敏）病因引起的常见条件。治疗涉及诊断潜在的原因和使用适当的疗法。可以解决多种病因，以及伴随的炎症的广谱疗法是非常有用的。在本综述中，我们讨论了局部眼科皮质类固醇和眼科配方的有用性，使皮质类固醇与抗感染性/抗生素组合治疗急性传染性结膜炎。方法：对发表的文献和相关治理指南进行审查。结果：局部皮质类固醇可用于治疗眼部炎症，但大多数治疗指南推荐一般在严重的结膜炎病例中使用类固醇。这部分是由于与类固醇使用相关的风险。这些风险包括延长腺病毒感染和增强/恶化的单纯性病毒感染，增加眼内压，青光眼和白内障的可能性。然而，大多数这些感知的风险都没有得到高质量的临床数据支持。它们也与长期类固醇用途有关，这些用途与传染性结膜炎的应用不同。临床数据表明，在用于短期治疗（<= 2周）时，将皮质类固醇与广谱抗感染性结合具有广谱抗感染性的皮质类固醇的眼科制剂可以是有效的并且 - 耐受性（<= 2周）。结论：皮质类固醇与抗感染性相结合，可能是急性结膜炎的有希望的治疗选择，这些选项可能会对其在其结膜炎治疗中的有效性和安全性的进一步证据进行进一步的证据。

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