Most children with conjunctivitis do not need treatment, study asserts

Parents should let conjunctivitis clear on its own rather than see an ophthalmologist for a prescription antibiotic, a recent article in The Lancet suggests.

Peter W. Rose, MD, and colleagues at the University of Oxford in England analyzed results from a randomized, double-masked, placebo-controlled study involving 163 children treated with chloramphenicol for acute infective conjunctivitis and 163 who were treated with a placebo drops. The patients ranged in age from 6 months to 12 years.

After 7 days, the conjunctivitis cleared in 86% of the children who had been given chloramphenicol and 83% of those given placebo drops.

According to a press release from the Lancet, even in children with a bacterial infection, “the cure rate did not differ significantly” — 85% for the chloramphenicol group and 80% for the control group.

“About half a day was gained in time to resolution between children treated with antibiotic and those with placebo, but this gain has to be weighed against the personal and healthcare costs of a condition that improves without treatment,” the researchers were quoted as saying in one news report on the study.

Primary care physicians treat about 1 million children per year in the United Kingdom for acute conjunctivitis and about 5 million in the United States, published reports noted.

Members of the British Medical Association said they believe patients will still benefit from antibiotic use in infective bacterial conjunctivitis.

Chloramphenicol was recently granted regulatory approval in England to be sold over the counter and without a prescription, according to the BBC. Chloramphenicol is the first antibiotic to be sold without a prescription in the United Kingdom.

Results from this study differ from previous studies that found that antibiotic therapy significantly improved conjunctivitis resolution. The authors speculated that previous studies may have focused on children with bacterial conjunctivitis and not those with viral or bacterial/viral conjunctivitis.