ABSTRACT

Purpose

To systematically review and critically appraise clinical practice guidelines (CPGs) and summarise the recommendations for non-infectious and infectious conjunctivitis

Methods

CPGs published on non-infectious and infectious conjunctivitis between 2010 and March 2020 were reviewed, evaluated, and selected using nine items from the Appraisal of Guidelines for Research and Evaluation II tool (4, 7, 8, 10, 12, 13, 15, 22 and 23). CPGs with an average score for items 4, 7, 8, 12, or 22 below 3 and/or a sum of the two researchers’ average score for all nine items less than 45 were excluded. Two authors independently extracted and validated the data using standardised forms.

Results

Fifteen CPGs from five sources remained for data extraction. CPGs consistently recommended non-pharmacological interventions (artificial tears, cold compress, avoidance or removal of allergens) for non-infectious conjunctivitis and pharmacological interventions (topical anti-histamine, mast-cell stabiliser and dual-acting agent) for allergy types. Observation without treatment was strongly recommended for non-herpetic viral and bacterial infections. Systemic and topical anti-viral was consistently recommended for herpetic viral conjunctivitis, while systemic and topical antibiotics were recommended for chlamydial and gonorrhoeal conjunctivitis. The methods used to assess the level of evidence and the strength of recommendation varied among CPGs.

Conclusions

There are a number of high-quality CPGs for non-infectious and infectious conjunctivitis. While there were a number of consistencies in the recommendations provided within these CPGs, several inconsistencies were also identified. Many of which related to the scope of practise of the targeted end-user of the particular guideline.

中文翻译：

---

感染性和非感染性结膜炎临床实践指南的系统评价

摘要

目的

系统回顾和批判性评估临床实践指南 (CPG) 并总结非传染性和传染性结膜炎的建议

方法

2010 年至 2020 年 3 月期间发表的关于非传染性和传染性结膜炎的 CPG 使用“研究和评估指南评估 II”工具中的 9 个项目（4、7、8、10、12、13、15、 22 和 23）。第 4、7、8、12 或 22 项平均得分低于 3 分和/或两位研究人员对所有 9 个项目的平均得分总和低于 45 分的 CPG 被排除在外。两位作者使用标准化表格独立提取和验证数据。

结果

来自五个来源的十五个 CPG 仍用于数据提取。CPG 一致建议对非感染性结膜炎进行非药物干预（人工泪液、冷敷、避免或去除过敏原），对过敏类型进行药物干预（局部抗组胺剂、肥大细胞稳定剂和双重作用剂）。对于非疱疹病毒和细菌感染，强烈建议不进行治疗观察。全身和局部抗病毒药物一直被推荐用于疱疹病毒性结膜炎，而全身和局部抗生素被推荐用于衣原体和淋病性结膜炎。用于评估证据水平和推荐强度的方法因 CPG 而异。

结论

有许多用于非传染性和传染性结膜炎的高质量 CPG。虽然这些 CPG 中提供的建议有许多一致之处，但也发现了一些不一致之处。其中许多与特定指南的目标最终用户的实践范围有关。