“Pink Eye” Antibiotic Overuse for Conjunctivitis

Is Your Doctor Prescribing the Wrong Treatment for Pink Eye?

Based on our own experiences as well as recommendations of the American Academy of Ophthalmology you should be aware that non eyecare practitioners tend to overprescribe antibiotics for a common eye infection that typically clears up without medication. A recent study suggests that most people with acute conjunctivitis, or pink eye, are getting the wrong treatment. About 60 percent of patients are prescribed antibiotic eyedrops, even though antibiotics are rarely necessary to treat this common eye infection.

About the Pink Eye Conjunctivitis Study

Researchers at the University of Michigan Kellogg Eye Center looked at data from a large managed care network in the United States. They identified the number of patients who filled antibiotic eye drop prescriptions for acute conjunctivitis. Then they evaluated the characteristics of patients who filled a prescription compared with those who did not. Of approximately 300,000 patients diagnosed with acute conjunctivitis over a 14-year period, 58 percent filled a prescription for antibiotic eye drops. Among them, 20 percent filled a prescription for an antibiotic-steroid combination. Antibiotic-steroid drops are inappropriate for most patients with acute conjunctivitis because it may prolong or exacerbate certain types of viral infection.

Even more troubling, the authors found that the odds of filling a prescription depended more on a patient’s socioeconomic status than the patient's risk for developing a more serious eye infection. For example, patients who wear contact lenses and those diagnosed with HIV/AIDS.

Pink eye affects 6 million people in the United States each year. There are three types: viral, bacterial, and allergic conjunctivitis. Antibiotics are rarely necessary to treat acute conjunctivitis. Most cases are caused by viral infections or allergies and do not respond to antibiotics. Antibiotics are often unnecessary for bacterial conjunctivitis because most cases are mild and would resolve on their own within 7 to 14 days without treatment.

The study also found:

• Primary care providers (family physicians, pediatricians, internal medicine physicians, and urgent care providers) diagnose a majority (83%) of patients. Only a minority were diagnosed by eye care providers such as ophthalmologists or optometrists.
• Patients diagnosed by a primary care or urgent care provider were two to three times more likely to fill prescriptions for antibiotic eye drops than patients diagnosed by an ophthalmologist.
• Patients who filled antibiotic prescriptions were significantly more likely to be white, younger, better educated, and more affluent than patients who did not fill prescriptions.

The authors say there are several reasons why antibiotics are over prescribed. It is a challenge to differentiate bacterial conjunctivitis from the viral and allergic forms. All three types may have overlapping features, such as a red eye, thin discharge, irritation, and sensitivity to light. Health care providers may tend to “err on the side of caution” and prescribe antibiotics “just in case.” Patients are often unaware of the harmful effects of antibiotics and may falsely believe that antibiotics are necessary for the infection to resolve.

If you or someone you know develops “pink eye” conjunctivitis please call Northwest Indiana Eye & Laser Center at 219-464-8223, or visit Northwest Indiana Eye & Laser Center, Google+ or facebook.com/nwindianaeyeandlaser. 

Northwest Indiana Eye & Laser Center offices are located at 502 Marquette Street, Valparaiso, Indiana 46383 and 1001 South Edgewood Drive, Knox, Indiana 46354.