When You Need Antibiotic Treatment-and When You Don’t

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The findings: Doctors sometimes inappropriately prescribe antibiotics to treat pinkeye. Pinkeye, or conjunctivitis, is an inflammation or infection in one or both eyes caused by a virus, bacteria, or an allergen. The condition is typically mild and clears up on its own. Only bacterial conjunctivitis should be treated with antibiotics, but they’re seldom needed for mild cases. Most cases are viral, especially among adults. Yet, when researchers at the University of Michigan Kellogg Eye Center analyzed the medical records of 340,372 Americans diagnosed with pinkeye, they were surprised to find that nearly 60 percent of patients filled a prescription for antibiotic eyedrops. The study, which was published in August 2017 in the journal Ophthalmology, also found that 20 percent of the prescriptions were for a combination antibiotic-steroid eyedrop-which can prolong or even worsen conjunctivitis.

The caveat: Symptoms-red eyes, discharge, itchiness, or burning-are similar for all causes of pinkeye, making it challenging for doctors to determine the cause. If your doctor suspects bacterial conjunctivitis, he or she may swab the eye discharge and send it to a lab to determine the cause. The researchers surmise that some providers may prescribe antibiotics as a precaution rather than delay immediate treatment. This practice may be partly driven by patients who mistakenly insist on an antibiotic.

What you should do: If your doctor prescribes antibiotic eyedrops, ask how sure he or she is that the cause is bacterial. If your infection isn’t severe, try soothing your eyes with cool, moist compresses (or warm, if they feel better). Wipe away any discharge with a tissue to prevent the infection spreading to the other eye or other people. For allergic conjunctivitis, over-the-counter antihistamines and “artificial tear” eyedrops may help. And always remove your contact lenses until your eyes feel better.