Antibiotics usually not needed for pink eye

For most kids with pink eye, also known as acute infective conjunctivitis, the condition will usually resolve on its own, without antibiotic treatment, results of a UK study suggest.

Pink eye often results from a bacterial infection and standard clinical practice is the prescription of antibiotic eyedrops or ointments, Dr. Peter Rose of the University of Oxford and colleagues explain in The Lancet. Previous studies showing that antibiotics were the best treatment for pink eye largely involved patients with severe forms of the disease.

The current study involved 326 children who were evaluated by a primary medical doctor for pink eye and were randomly assigned to receive eye drops containing antibiotic or inactive “placebo” drops. The children were otherwise healthy and had no disorders that would compromise the body’s ability to fight off infection.

Testing revealed that about 80 percent of infections were bacterial. Nevertheless, 86 percent of those treated with antibiotics and 83 percent of those in the placebo group were clinically cured after 7 days, despite the fact that only 40 and 23 percent, respectively, showed no evidence of bacterial infection at 7 days.

Thus, the authors deduce, destroying all the bacteria present is not essential for clinical cure. During 6 weeks of follow-up, a return of pink eye was equally rare in both groups.

The results show that healthy children with pink eye do not need an antibiotic when first seen by their primary medical doctor, Rose’s team writes. “Parents should be encouraged to treat children themselves without medical consultation, unless their child develops unusual symptoms or the symptoms persist for more than a week,” they conclude.

SOURCE: The Lancet, online June 22, 2005.

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