Long-term treatment outcomes of pediatric blepharokeratoconjunctivitis without systemic antibiotics

Purpose The optimal treatment of pediatric blepharokeratoconjunctivitis (PBKC) is not well established, and systemic antibiotic therapy is considered an important component of its management. This study aimed to report the therapeutic outcomes of PBKC in the absence of long-term systemic antibiotic therapy. Methods This retrospective case series included patients with PBKC aged < 18 years who visited Ajou University Medical Center between May 2020 and July 2022. The patients were treated with lid scrubs and topical ocular therapies. We excluded those with less than 3 months of follow-up or systemic antibiotic use. Based on the severity of PBKC, treatments included lid scrubs, topical antibiotics, steroids, and immunomodulatory drugs. Clinical characteristics and disease flare-ups were monitored. Results Of the 34 patients identified, 21 patients were included. Overall, 2 of the excluded patients used systemic antibiotics, and 11 patients had less than 3 months of follow-up. The mean age was 10.7 years, and the mean follow-up duration was 10.24 months. The Oxford staining score, blepharitis grading scale score, and lid margin telangiectasia grade improved with treatment. In total, 2/21 patients (14%) experienced flare-ups during the follow-up period; these were controlled with topical antibiotics and steroids within 1 month. Conclusion PBKC can be controlled with lid scrubs and topical ocular therapies without long-term systemic antibiotic therapy. Additional therapeutic studies and clinical trials are required to establish more effective treatment strategies.