acute bacterial conjunctivitis

WEDNESDAY, July 10, 2024 -- More than two-thirds of children with conjunctivitis have a prescription filled for topical antibiotics within one day of an ambulatory care visit, according to a research letter published online June 27 in JAMA Ophthalmology . Daniel J. Shapiro, M.D., M.P.H., from the University of California, San Francisco, and colleagues examined prescription of topical antibiotic treatment and the association of treatment with subsequent health care use among individuals aged 1 to 17 years with ambulatory care encounters who had a conjunctivitis diagnosis. A total of 44,793 ambulatory care encounters were included. The researchers found that after 69 percent of encounters, topical antibiotics were dispensed within one day. Topical antibiotics were dispensed less frequently after visits to eye clinics, for children aged 6 to 11 years, and for viral conjunctivitis (34, 66, and 28 percent, respectively). After 3.2 percent of index encounters, ambulatory care revisits for conjunctivitis occurred within 14 days. After 1.4 percent of index encounters, all-cause revisits with a same-day antibiotic dispensation occurred. No association was seen for topical antibiotic treatment with ambulatory care revisits for conjunctivitis or revisits with same-day topical antibiotic dispensation in a multivariable analysis. Hospitalizations for conjunctivitis and emergency department revisits occurred for 0.03 and 0.12 percent of children, respectively, with no differences seen across exposure groups. "Revisits and new antibiotic dispensations were rare, regardless of initial topical antibiotic treatment, suggesting that not receiving antibiotics may not be associated with additional health care use," the authors write. "Given that antibiotics may not be associated with improved outcomes or change in subsequent health care use and are associated with adverse effects and antibiotic resistance, efforts to reduce overtreatment of acute infectious conjunctivitis are warranted."