Conjunctivitis no need for antibiotics

Healthfacts, July, 2005

Children with conjunctivitis, also known as pinkeye, are typically given antibiotic eyedrops. The practice should be stopped, according to the authors of a new study of 326 British children, aged six months to twelve years.

The children with conjunctivitis, an inflammation of the mucous membrane that covers the surface of the eyeball, were randomly assigned to be treated with antibiotic eyedrops called chloramphenicol or placebo eyedrops. Although 80% of the children had bacterial conjunctivitis, which would indicate that antibiotics eyedrops are appropriate, the study's results did not favor the drug treatment.

The children given antibiotic eyedrops did not have fewer adverse effects than the others, nor were they less likely to experience a recurrence. Approximately the same percentage of children got better in seven days (84%) whether they were given antibiotic eyedrops or not. The children given chloramphenicol eyedrops had a slightly shorter duration (eight hours) of eye symptoms. One child in the group taking antibiotics, however, suffered a drug-related side effect--swollen eyelids and face. At the sixweek followup after diagnosis, relapse and complications were rare, even among the untreated children in the placebo group

This study, led by Peter W. Rose, M.D., of the University of Oxford, England, and colleagues, was reported online in the British journal, The Lancet. It is the first trial of its kind to be conducted in the primary care setting where chloramphenicol eyedrops are the standard treatment for conjunctivitis in children living in the U.K. American children, on the other hand, are more likely to receive another antibiotic, either erythromycin ophthalmic ointment or sulfa ophthalmic eyedrops.

Dr. Rose and colleagues concluded that conjunctivitis is a self-limiting condition, which means that it will clear up on its own. Consequently, antibiotic treatment is unnecessary. They suggest that doctors advise parents to keep the affected eye clean and to come in if the child develops unusual symptoms or if the symptoms persist for more than a week.