|Abstract||This study aimed to assess different management strategies for acute infective conjunctivitis using an open, factorial, randomised controlled trial in 30 general practices in southern England. 307 adults and children with acute infective conjunctivitis were participants. One of three antibiotic prescribing strategies—immediate antibiotics (chloramphenicol eye drops; n = 104), no antibiotics (controls; n = 94), or delayed antibiotics (n = 109); a patient information leaflet or not; and an eye swab or not were used. |
Results showed that prescribing strategies did not affect the severity of symptoms but the duration of moderate symptoms was less with antibiotics. Compared with no initial offer of antibiotics, antibiotic use was higher in the immediate antibiotic group, as was belief in the effectiveness of antibiotics, and intention to reattend for eye infections. A patient information leaflet or eye swab had no effect on the main outcomes. Reattendance within two weeks was less in the delayed compared with immediate antibiotic group.
Delayed prescribing of antibiotics is probably the most appropriate strategy for managing acute conjunctivitis in primary care. It reduces antibiotic use, shows no evidence of medicalisation, provides similar duration and severity of symptoms to immediate prescribing, and reduces reattendance for eye infections.