Conjunctivitis -- the goopy eye infection better known as pinkeye -- needn't always be treated with antibiotics, finds a study published online last week by the British medical journal The Lancet. Of 326 kids with pinkeye who were studied, nearly as many who received placebo drops (83 percent) were symptom-free after seven days as those who got antibiotic drops (86 percent). While participants receiving the placebo took longer to get better than those on antibiotics (by the third day, 64 percent of those on antibiotics were cured, compared with 54 percent of those on placebo), most had caught up by the end of the week. Lead author Peter Rose of the University of Oxford suggests that letting pinkeye resolve on its own could eliminate unnecessary doctor visits and prescription costs and would comport with efforts to curb antibiotic resistance. But he acknowledges that policies banning kids with pinkeye symptoms from school make the use of antibiotics appealing.
Blurry Vision Mohamad Jaafar, division chief of ophthalmology at Children's National Medical Center, says the study doesn't convince him that antibiotics aren't needed to fight pinkeye. Jaafar notes that while the difference in speed with which the two groups were cured might not seem great, each extra day means more misery.
Another issue is transmission, which generally occurs when an infected kid rubs his eye and then touches something; another kid who touches the same thing and rubs his eye may end up with pinkeye. Knocking the germs out early can help control spread of the infection, Jaafar said, and it allows kids to be responsibly sent back to school or day care sooner. Children generally can return to school or day care as soon as their symptoms disappear, which Jaafar said can be as soon as 24 hours after a good antibiotic is administered.
Do Drop In Jaafar calls the study's use of chloramphenicol as the test drug a serious flaw. While the study calls it the most commonly used preparation for pinkeye, the antibiotic is "archaic," according to Jaafar, who said it is less effective than newer drugs and needs to be taken more frequently. Antibiotics currently used in the United States -- such as Vigamox eye drops, erythromycin eye ointment and Polytrim eyedrops -- cure pinkeye within seven days in almost 100 percent of cases, he said. Antibiotic eyedrops are not thought to contribute to bacterial resistance, Jaafar added, as they're applied in small quantities directly to the infected area. Moreover, he said, kids with pink, painful, mucus-filled eyes should see a doctor, as such symptoms can have causes other than conjunctivitis.
-- Jennifer Huget