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Conjunctivitis: Do antibiotics help?

Last Update: November 7, 2012; Next update: 2015.

In more than half of all people who have conjunctivitis, the infection goes away without treatment within a week. Antibiotic eye drops or ointments can speed up recovery. Side effects are very rare.

Conjunctivitis can be caused by viruses or bacteria. But because conjunctivitis usually goes away so quickly, it is generally not worth doing tests to find out if it is a bacterial or viral infection. Doctors often prescribe antibiotics just in case, in the form of eye drops or ointments. They often turn out to be useless though, because they only fight bacteria and not viruses.

Research on antibiotics in the treatment of conjunctivitis

Research groups from England, the Netherlands and Australia have evaluated 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, or did not have any treatment at first.

The researchers only looked at 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 twelve suitable studies, involving about 4,000 children and adults.

Antibiotics can speed up recovery

Overall, the analysis of the studies showed that conjunctivitis goes away slightly faster if antibiotics are used. The following results were for people who saw a doctor because they had conjunctivitis:

In other words, antibiotics were found to speed up recovery in 9 out of 100 people.

It took longer for the symptoms to clear up in patients who were treated by a specialist - even in those patients who were treated with antibiotics. One reason for this could be that people who were treated by a specialist had a more severe case of conjunctivitis. The number of people who benefited from antibiotics was however similar to the number amongst patients who went to see a normal doctor.

The studies did not look into whether antibiotics helped lower the risk of the infection spreading.

None of the studies reported on any side effects of the antibiotics. Nevertheless, antibiotics should still only be used when absolutely necessary. Excessive use or incorrect use can help bacteria build up a resistance, meaning that antibiotics would be less effective when treating other conditions.

Sources

  • Jefferis J, Perera R, Everitt H, van Weert H, Rietveld R, Glasziou P et al. Acute infective conjunctivitis in primary care: who needs antibiotics? An individual patient data meta-analysis. Br J Gen Pract 2011; 61(590): e542-548. [PMC free article: PMC3162176] [PubMed: 22152728]
  • 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.

© IQWiG (Institute for Quality and Efficiency in Health Care)

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