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Most Kids Getting Antibiotics for Pink Eye Against Guideline Advice

— "There are more supportive measures we can take without resorting to antibiotic eye drops"

MedpageToday
A microscope image of gram-negative, Haemophilus influenzae bacteria.
(William B. Cherry/CDC via AP)

Doctors are prescribing antibiotics to most kids and teens who have pink eye, despite guidelines that discourage their use, researchers reported.

More than two-thirds of U.S. children and teens who saw a doctor for conjunctivitis left with a prescription for antibiotic eye drops, according to Daniel Shapiro, MD, MPH, of the University of California San Francisco, and colleagues, writing in .

The American Academy of Ophthalmology (AAO) that doctors not routinely give out antibiotics for the condition, which usually clears up on its own. Antibiotics don't work at all on viruses -- the most common cause of pink eye. And even mild eye infections from bacteria will in most cases, according to AAO.

Pink eye is highly contagious and causes red, swollen, and sometimes itchy eyes. Often, a chilled, wet towel and artificial tears are enough to ease symptoms.

For their study, Shapiro and colleagues used a nationwide database of insurance claims from 2021. Nearly 45,000 children received care for pink eye at a doctor's office, eye clinic, or emergency room, and 69% were prescribed antibiotics, which come in drops and ointments.

Whether the patients were treated or not, return visits to healthcare providers for pink eye were rare -- under 4%. Doctor's offices gave antibiotics most often -- to 72% of patients, compared with 57% for emergency rooms and 34% for eye clinics.

The lower rate in eye clinics may be because they have the tools to figure out what is actually causing the pink eye and treat accordingly, said AAO spokesperson Rupa Wong, MD, a pediatric ophthalmologist at Honolulu Eye Clinic.

Shapiro said he understands why parents might be alarmed when their child has an infection. "The eye looks red and nasty and so it's pretty striking and scary," he said. But antibiotics shouldn't be overused if they aren't going to help, he added.

The study didn't dig into the specifics of why the antibiotics were prescribed or the outcomes. But the fact that return visits were rare in either case suggests that patients are not at higher risk of complications or serious problems if they don't get a prescription, Wong said. "There are more supportive measures we can take to make your child feel comfortable without resorting to antibiotic eye drops."