{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T22:11:21Z","timestamp":1766182281655,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Ophth"],"accepted":{"date-parts":[[2016,10,22]]},"published-print":{"date-parts":[[2016,11,11]]},"abstract":"<jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>To determine whether there was a change in the resistance pattern of bacteria isolated from cases of conjunctivitis following the introduction of over-the-counter availability of chloramphenicol in 2005.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design and setting<\/jats:title>\n                  <jats:p>Retrospective review of laboratory records for adult patients with suspected bacterial conjunctivitis between 2001 and 2012 attending the Royal Liverpool University Hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Patients with suspected bacterial conjunctivitis. Organisms were identified by standard laboratory methods. Scanty growth and normal flora were considered as a negative result. For positive results, susceptibility testing was undertaken as per British Society for Antimicrobial Chemotherapy guidelines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Prevalence of groups of bacteria associated with acute conjunctivitis and their resistance to chloramphenicol, ciprofloxacin, gentamicin, and methicillin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 8209 conjunctival swabs were reviewed; 1300 (15.8%) were considered positive, of which 977 (75.2%) and 323 (24.8%) bacteria were identified as Gram positive and Gram negative, respectively. <jats:italic>Staphylococcus aureus<\/jats:italic> was the most prevalent organism identified. Resistance of all bacterial isolates to chloramphenicol was 8.4% varying from 3.0% to 16.4% while that for ciprofloxacin and gentamicin was 16.4% and 14.0%, respectively. Methicillin resistance among <jats:italic>S. aureus<\/jats:italic> was 8.3%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Resistance to chloramphenicol has remained stable since being made available over the counter. Among Gram-positive bacteria, the most prevalent causative agent of bacterial conjunctivitis, chloramphenicol sensitivity remains high.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjophth-2016-000006","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T09:18:50Z","timestamp":1715764730000},"page":"e000006","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Adult bacterial conjunctivitis: resistance patterns over 12 years in patients attending a large primary eye care centre in the UK"],"prefix":"10.1136","volume":"1","author":[{"given":"Alexander","family":"Silvester","sequence":"first","affiliation":[{"name":"St Paul\u2019s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Neal","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Royal Liverpool University Hospital, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Czanner","sequence":"additional","affiliation":[{"name":"Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Briggs","sequence":"additional","affiliation":[{"name":"St Paul\u2019s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Harding","sequence":"additional","affiliation":[{"name":"Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Kaye","sequence":"additional","affiliation":[{"name":"St Paul\u2019s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,11,11]]},"reference":[{"key":"2025090110090117000_1.1.e000006.1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2415-9-13"},{"key":"2025090110090117000_1.1.e000006.2","first-page":"962","article-title":"Topical antibiotics for acute bacterial conjunctivitis: Cochrane systematic review and meta-analysis update","volume":"55","author":"Sheikh","year":"2005","journal-title":"Br J Gen Pract"},{"key":"2025090110090117000_1.1.e000006.3","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp09X473132"},{"key":"2025090110090117000_1.1.e000006.4","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/ijpp.12033","article-title":"An investigation of prescription and over-the-counter supply of ophthalmic chloramphenicol in Wales in the 5 years following reclassification","volume":"22","author":"Du","year":"2014","journal-title":"Int J Pharm Pract"},{"key":"2025090110090117000_1.1.e000006.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2007.03.076"},{"key":"2025090110090117000_1.1.e000006.6","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s00417-010-1426-6","article-title":"Shifting trends in in vitro antibiotic susceptibilities for common bacterial conjunctival isolates in the last decade at the New York Eye and Ear Infirmary","volume":"249","author":"Adebayo","year":"2011","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"2025090110090117000_1.1.e000006.7","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1038\/eye.1998.221","article-title":"Lack of evidence for systemic toxicity following topical chloramphenicol use","volume":"12(5 Pt)","author":"Walker","year":"1998","journal-title":"Eye"},{"key":"2025090110090117000_1.1.e000006.8","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.10382"},{"key":"2025090110090117000_1.1.e000006.9","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm110"},{"key":"2025090110090117000_1.1.e000006.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)17907-0"},{"key":"2025090110090117000_1.1.e000006.11","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.09-4638"},{"key":"2025090110090117000_1.1.e000006.12","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1111\/ceo.12087","article-title":"Ocular penetration of topical antibiotics: study on the penetration of chloramphenicol, tobramycin and netilmicin into the anterior chamber after topical administration","volume":"41","author":"Cagini","year":"2013","journal-title":"Clin Exp Ophthalmol"},{"key":"2025090110090117000_1.1.e000006.13","doi-asserted-by":"publisher","DOI":"10.1097\/01.ico.0000263125.99262.42"},{"key":"2025090110090117000_1.1.e000006.14","unstructured":"Public Health England. Voluntary reporting of Staphylococcus aureus bacteraemia in England, Wales and Northern Ireland,\u00a02012 [Health Protection Report]. 2013, 7(29): HCAI."},{"key":"2025090110090117000_1.1.e000006.15","doi-asserted-by":"crossref","first-page":"813979","DOI":"10.1155\/2015\/813979","article-title":"Bacterial spectrum and antibiotic resistance patterns of ocular infection: differences between external and intraocular diseases","volume":"2015","author":"Wang","year":"2015","journal-title":"J Ophthalmol"},{"key":"2025090110090117000_1.1.e000006.16","first-page":"4315","article-title":"Monitoring of antimicrobial resistance of pathogens causing nosocomial infections in ophthalmic hospital","volume":"23","author":"Mao","year":"2013","journal-title":"Chin J \u00a0Nosocomiol"},{"key":"2025090110090117000_1.1.e000006.17","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2012-302251"}],"container-title":["BMJ Open Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjophth-2016-000006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T17:09:07Z","timestamp":1756746547000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjophth.bmj.com\/lookup\/doi\/10.1136\/bmjophth-2016-000006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,11]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,11,11]]},"published-print":{"date-parts":[[2016,11,11]]}},"alternative-id":["10.1136\/bmjophth-2016-000006"],"URL":"https:\/\/doi.org\/10.1136\/bmjophth-2016-000006","relation":{},"ISSN":["2397-3269"],"issn-type":[{"type":"electronic","value":"2397-3269"}],"subject":[],"published":{"date-parts":[[2016,11,11]]}}}