Bacterial conjunctivitis in children: antibiotic eye drops only if eye washing is ineffective.

(1) Acute infectious conjunctivitis in children is often due to bacterial infection. (2) Systematic use of local antibiotic therapy may not be needed. A systematic review and two recent trials conducted in the primary care setting provide interesting results. (3) The results of several trials, and specifically of a study of children (excluding neonates) with uncomplicated conjunctivitis in primary healthcare, show that about 50% of patients recover within four days without antibiotic therapy. Antibiotic therapy seems to hasten recovery by less than half a day. (4) A trial involving adults and children at least one year of age compared immediate antibiotic eye drop therapy versus antibiotic eye drops given only when symptoms persisted for three days. A control group received no antibiotic treatment. Immediate antibiotic therapy hastened recovery by slightly more than half a day in comparison with delayed treatment. (5) In practice, when a child presents with conjunctivitis, it is reasonable to wait and see how the symptoms evolve before prescribing local antibiotics.