Children May Not Need Antibiotics for Acute Infective Conjunctivitis

The above headline appeared in a June 24, 2005 article from the online Medscape from WebMD. This article was based on the findings of a new study published in the June 22, 2006 British research journal, The Lancet.

In this study 326 children with a diagnosis of conjunctivitis ranging from age 6 months to 12 years were randomly selected from medical practices in the UK. These children were separated into two groups. One group received eye drops of the antibiotic chloramphenicol, while the other group got placebo eye drops. Neither the doctors nor the patients knew whether they were getting the placebo or the real antibiotic.

The children were re-examined at day 7 and a follow up was done 6 weeks later. Eye swabs were collected for bacterial and viral analysis. The results of the study on day seven showed that of the 155 children in the placebo group, 128 of them, or 83% were listed as cured. This compared to 140 being listed as cured of the 162 children, representing 86%, in the group that actually got the antibiotic chloramphenicol. The difference noted is statistically insignificant, therefore researchers noted no real difference between the two groups.

In the 6 week follow up researchers found that further conjunctivitis episodes occurred in seven children (4%) receiving chloramphenicol and in five children (3%) receiving placebo. They also found that any additional adverse events occurred at a similar rate in both groups.

Lead author Peter W. Rose, from the University of Oxford, England commented, "We have shown that symptoms resolve without antibiotics in most children with acute infective conjunctivitis. The health economic argument against antibiotic prescription for acute conjunctivitis is compelling."

The conclusion and recommendations of the authors were, "Parents should be encouraged to cleanse their children's eyes if an antibiotic is not prescribed. 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."