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Conjunctivitis: Can antibiotics help?

Last Update: May 20, 2015; Next update: 2018.

Almost half of all simple cases of conjunctivitis clear up within ten days without any treatment. If the conjunctivitis is caused by bacteria, antibiotic eye drops or creams can help speed up the process somewhat. If it is caused by a virus, antibiotics do not help.

Conjunctivitis is usually caused by viruses or bacteria. The symptoms of viral and bacterial conjunctivitis are very similar, making it difficult to tell them apart. Doctors generally do not test to see which germs are causing the infection. But many prescribe antibiotic eye drops or creams just in case, even though these medications are only effective against bacteria.

Evaluation of antibiotics for treating conjunctivitis

Researchers from England and the Netherlands looked at studies on the treatment of conjunctivitis with antibiotics. They wanted to find out whether antibiotics help in the treatment of ordinary conjunctivitis, and what possible disadvantages they might have.

The researchers only analyzed the results of studies that compared at least two groups of people. One group of participants used antibiotic eye drops or ointments. The other group used non-antibiotic eye drops or ointments.

The researchers only included studies in which the participants were randomly assigned to one of the treatment groups. This kind of study, called a randomized controlled trial, delivers the most reliable results.

The researchers found a total of eleven studies involving nearly 3,700 children and adults.

Antibiotics can speed up recovery

Analysis of the studies shows that acute conjunctivitis goes away somewhat faster when antibiotics are used. The following results were found for people who went to a family doctor or eye specialist because of conjunctivitis:

In other words, antibiotics helped to speed up the recovery in 10 out of 100 people within this time.

None of the studies reported on side effects of the antibiotics. They also did not look into whether antibiotics lower the risk of the infection spreading.

Sources

  • Sheikh A, Hurwitz B, van Schayck CP, McLean S, Nurmatov U. Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev 2012; (9): CD001211. [PubMed: 22972049]
  • IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

    Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. We do not offer individual consultations.

    Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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