Should antibiotics be used for conjunctivitis in children?

One in eight children in the UK has an episode of acute infectious conjunctivitis each year. Usually, in such cases, the doctor prescribes an antibiotic for topical use. However, the data on whether to prescribe antibiotics for infectious conjunctivitis are contradictory.

A group of British doctors has conducted a randomized, double-blind study to compare the effectiveness of eye drops with chloramphenicol and placebo in children with infectious conjunctivitis on an outpatient basis. The study involved 326 children aged 6 months. up to 13 years old. The children were randomized into 2 groups: the chloramphenicol group and the placebo - 163 children each. A smear was taken from each patient for bacteriological and virological studies. The main efficacy criterion was recovery on day 7 from the start of treatment. The children's condition was assessed in the diaries that their parents filled out. The follow-up period was 6 weeks, during which the frequency of relapses was determined. Failure to follow up on 9 children (1 in the chloramphenicol group and 8 in the placebo group).

Recovery was observed in 140 (86%) of 162 patients in the chloramphenicol group and in 128 (83%) of 155 children in the control group. Relapse of conjunctivitis within 6 weeks was observed in 7 (4%) children who received the antibiotic and in 5 (3%) who received a placebo. The differences in these indicators were not statistically significant. The frequency of eradication of the bacterial pathogen was higher in the antibiotic group (40%) than in the placebo group (23%), but this did not affect clinical recovery. Adverse drug reactions were also seen rarely in children in both groups.

Currently, in cases of acute infectious conjunctivitis, the norm is the local use of antibiotics. However, due to the increase in antibiotic resistance, the need to use antibiotics for conjunctivitis becomes questionable. The results of this study indicate that acute infectious conjunctivitis that occurs in children on an outpatient basis is prone to self-resolution, and usually an antibiotic is not necessary in such situations.