Explain That Antibiotics Aren’t Often Needed for Pink Eye

You’ll get questions about managing pink eye (conjunctivitis).

Explain viruses are the most common cause in adults...and bacteria are the most common cause in kids. But conjunctivitis can also have noninfectious causes, such as allergies.

Use this chart to help assess symptoms...and guide treatment.

PL Conjunctivitis

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Avoid topical corticosteroids in most cases...they can prolong certain infections and incorrect use can do more harm than good.

Refer to a prescriber if patients report vision changes, light sensitivity, or pain...or a rash or blisters around the eye or on the eyelid, which may indicate a herpes or shingles infection.

Direct patients wearing contact lenses to remove them ASAP...and to contact their prescriber to rule out a corneal ulcer or other issues.

Recommend measures to relieve symptoms, such as cool compresses for swelling or itchiness...or warm compresses to soften crusts. Suggest a lubricating eye drop (Refresh Tears, etc) to reduce irritation.

To limit spreading infection, emphasize washing hands frequently...not touching the eyes or sharing towels...discarding eye makeup...etc.

When an antibiotic is needed, watch for mix-ups. For instance, dispensing ciprofloxacin OTIC solution instead of OPHTHALMIC solution can lead to severe burning and eye pain.

Provide tips for appropriate administration. For example, tell patients to tilt their head back...pull down on the lower eyelid to form a “pocket”...and look up before instilling a drop.

Or parents giving drops to kids can have the child close their eye...place a drop in the inner corner of the closed eyelid...then have the child open the eye slowly to allow the drop to roll in.

Key References

  • Cheung AY, Choi DS, Ahmad S, et al; American Academy of Ophthalmology Preferred Practice Pattern Cornea/External Disease Panel. Conjunctivitis Preferred Practice Pattern. Ophthalmology. 2024 Apr;131(4):P134-P204.
  • Mahoney MJ, Bekibele R, Notermann SL, et al. Pediatric Conjunctivitis: A Review of Clinical Manifestations, Diagnosis and Management. Children (Basel). 2023 Apr 29;10(5):808.
  • Yeu E, Hauswirth S. A Review of the Differentia Diagnosis of Acute Infectious Conjunctivitis: Implications for Treatment and Management. Clin Ophthalmol. 2020 Mar 12:14:805-813.
  • Azari AA, Barney NP. Conjunctivitis: A Systematic Review of Diagnosis and Treatment. JAMA. 2013 Oct 23;310(16):1721-9.
Pharmacist's Letter. July 2024, No. 400702


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