The researchers reported that doctors prescribe antibiotics to most children and adolescents with conjunctivitis, despite guidelines discouraging its use.
Antibiotics are not necessary to treat conjunctivitis
More than two-thirds of American children and adolescents who saw a doctor for conjunctivitis returned with a prescription for antibiotic eye drops, their research found. The American Academy of Ophthalmology recommends that doctors not routinely give antibiotics for what is also called conjunctivitis, which usually clears up on its own.
Antibiotics do not work at all on viruses, the most common cause of conjunctivitis. And even mild eye infections caused by bacteria clear up on their own in most cases, the medical group says.
Conjunctivitis is highly contagious and causes red, swollen, and sometimes itchy eyes. Often, a cold, wet washcloth and artificial tears are enough to relieve symptoms.
For their study, the researchers used a national database of insurance claims from 2021. Nearly 45,000 children received treatment for pink eye at a doctor’s office, eye clinic, or emergency room, and 69% were prescribed antibiotics, available in drops and ointments.
According to a study published in the journal JAMA Ophthalmology regardless of whether they were treated or not, follow-up visits to the doctor for conjunctivitis were rare, less than 4%.
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Doctors’ offices administered more antibiotics to 72 percent of patients, compared to emergency rooms at 57 percent and eye clinics at 34 percent.
That may be because eye clinics have the tools to figure out what’s actually causing pink eye and treat it accordingly, said Dr. Rupa Wong, a pediatric ophthalmologist at the Honolulu Eye Clinic and spokesperson for the ophthalmology group.
Dr. Daniel Shapiro, a pediatric emergency physician and co-author of the study, said he understands why parents might be alarmed when their child has an infection.
“The eye looks red and unpleasant and so it’s quite surprising and scary,” said Shapiro, of the University of California, San Francisco.
But we should not abuse antibiotics if they are of no use, he said.
The study did not go into detail about why the antibiotics were prescribed or the outcome. But the fact that return visits were rare in both cases suggests that patients are not at greater risk of complications or serious problems if they don’t get a prescription, Wong said.
“There are additional supportive measures we can take to make your child feel comfortable without resorting to antibiotic eye drops,” Wong said.
What Parents Need to Know About Conjunctivitis
A case of pink eye, also known as conjunctivitis, used to mean a trip to the doctor, antibiotics, and keeping your child home from school. That’s no longer the case. Mayo Clinic pediatrician Dr. Marcie Billings explains what parents should know about this common viral infection.
“Conjunctivitis is actually an inflammation of the conjunctiva, a thin layer of tissue that covers the white part of the eye and the bottom of the eyelid.”
This can lead to inflammation of the blood vessels, which tends to cause redness. Dr. Billings says most cases are caused by a virus.
“The virus that causes pinkeye is essentially the same virus that causes the common cold.”
The most common symptoms are redness in one or both eyes, itching or gritty sensation in the eyes, and discharge.
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Treatment for pink eye no longer involves antibiotics. “Viruses, as we know, do not respond to antibiotics,” says Dr. Billings.
Start with supportive therapy. Use a cool compress on your eyes and consider using artificial tears. It also means you don’t have to keep your child home from school.
“You would send your child to school if they had a runny or stuffy nose, as long as they were able to participate in normal school activities. Pink eye or viral conjunctivitis are no different,” says Dr. Billings
You can also manage and prevent the spread of the virus with good hand hygiene. Wash your hands often, do not reuse towels, and change pillowcases often. Talk to your doctor if you have any concerns, if symptoms do not improve after three days, or if your child has eye pain or vision changes.
What is conjunctivitis?
Pink eye is extremely common in children. According to the Centers for Disease Control and Prevention, public school students in the United States miss 3 million days of school each year due to conjunctivitis.
Dr. Tina Ardon, a Mayo Clinic family physician, explains what you should know about this contagious condition.
“Pink eye, or the medical term is conjunctivitis, is typically an irritated red or pink eye that may present with other symptoms, such as watery eyes, itching, and sometimes pain and discharge,” says Dr. Ardon.
Conjunctivitis is an inflammation of the transparent membrane that lines the eye and eyelid. It is most often caused by a virus, but sometimes bacterial infections and allergies can also be responsible.
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“How we treat pinkeye depends on what’s causing it,” says Dr. Ardon. “Usually, we’re still dealing with viruses. So it will resolve on its own without intervention. Sometimes we’ll consider treating it with antibiotic eye drops if it’s bacterial.”
He says that, like colds and flu, pinkeye is contagious and that it is essential to take certain precautions.
“Most patients may be at risk for this condition if they touch someone who has pink eye, rub their eyes, maybe touch their face, or don’t wash their hands consistently,” says Dr. Ardon.
Because conjunctivitis is often viral, antibiotics usually do not help. Treatment focuses on symptom relief.
“They might feel a little more comfortable if they used items like a warm compress to relieve some of their symptoms. And rest, once again, can be really helpful,” says Dr. Ardon.
Help your children avoid getting pink eye
As kids head back to school, there are many illnesses you should be aware of as a parent. A highly contagious infection is conjunctivitis, commonly known as “pink eye,” which many children and even adults contract at some point in their lives. In fact, pink eye is the most common eye problem among children with three million cases of pink eye per year in the United States. For this reason, it is important to know the symptoms and treatment, so you can quickly manage the symptoms and avoid spreading them to others.
The three most common types of pink eye include allergic pink eye, bacterial pink eye, and viral pink eye.
Here are some symptoms your child may experience with the different types of conjunctivitis:
•Pink or red color in the whites of the eyes.
•Swelling of the eyes.
•Increased tear production.
•Yellow-green pus discharge or crusting on the eyelids or eyelashes.
•Itching, irritation or burning.
•Cold, flu or other respiratory symptoms.
•Sensitivity to bright light.
•Swollen or tender •lymph node in front of the ear, as lymph nodes act as filters in the body helping to fight viruses and bacteria.
For children, the infection is particularly highly transmittable because it is more difficult to prevent them from touching their eyes. At school, they can infect other children by sharing toys and other equipment. If your child has any of these symptoms, it is important to keep them home from school and visit a pediatrician or pediatric ophthalmologist.
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Depending on the type of conjunctivitis, your doctor may choose to treat the infection in various ways, including antihistamine medications, antibiotic ointments or drops, or recommending cold compresses.
Here are some other things you can do to prevent the infection from spreading to yourself or other children:
•Use clean towels and sheets, do not let children at home share pillows or towels.
•Wash regularly used fabric clothing in hot water daily.
•Clean the child’s glasses and avoid the use of contact lenses.
•Wash your hands regularly and avoid touching your eyes and face.
•If your child is a preteen or teenager, make sure they don’t share mascara or makeup. Throw away any eye makeup after a conjunctivitis diagnosis.
Because children grow and develop rapidly, seeing a pediatric ophthalmologist is a great way to know if your child’s vision is healthy and if his or her visual needs are being met. If your child shows signs of conjunctivitis, it is important to seek treatment immediately.
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