Antibiotics No Help for Pinkeye?

June 22, 2005 -- Kids with pinkeye don't get better faster if they get antibiotic eyedrops, a British study shows.

The surprising finding suggests that pinkeye -- what doctors call conjunctivitis -- goes away by itself. Even so, doctors aren't likely to stop prescribing antibiotic eyedrops for this very common childhood problem.

The finding comes from a careful study of 326 children aged 6 months to 12 years led by Peter W. Rose, MD, of the University of Oxford in England. Half the kids were treated with antibiotic eyedrops. The other half got nonmedicated lubricating eyedrops.

Seven days later, 86% of the kids who got antibiotic eyedrops were cured. So were 83% of the kids who got artificial tears. The findings appear in the June 22 issue of The Lancet.

"The benefits of antibiotics for pinkeye are marginal," Rose tells WebMD. "Pinkeye is a mild condition. Usually it gets better by itself. What I now tell parents is that I don't want to give antibiotics to a child unless the parents really want it. So rather than a knee-jerk decision to give antibiotics whenever I see a kid with a sticky eye, I would share this decision with the parents."

Rose followed the kids not treated with antibiotics to see if there was any risk of serious infections.

"We followed 163 kids with conjunctivitis not treated with antibiotics, and not one got anything more serious," he says. "Parents are not taking too big a risk by not giving children antibiotics for their conjunctivitis."

Rinsing Away Bacteria

Antibiotics don't help infections caused by viruses. And the most common cause of pinkeye is a virus infection, says eye expert Kuldev Singh, MD, professor of ophthalmology at Stanford University.

But even when Rose looked only at kids with bacterial eye infections, he still found no benefit for antibiotic eyedrops.

He suggests that this may be because lubricating eyedrops help wash away bacteria. Singh agrees.

"The eye has the ability to fight off infections on its own. And one of the most important things that helps is irrigation," Singh tells WebMD. "Just rinsing the bacteria out of the eye can have a positive effect. But many of these patients would get better anyway, even without any treatment."

So does this mean antibiotic eyedrops are history? No way, Singh says. He notes that U.S. doctors use a different class of antibiotics than the one used in the U.K. Both kinds of antibiotic are extremely safe and don't seem to encourage the growth of drug-resistant superbugs. So even if the benefit is not huge, it outweighs the risk.

"I am not convinced we should withhold antibiotics for conjunctivitis, despite the findings of this study," Singh says.

Singh also notes that infections are only one cause of pinkeye. He recommends that parents take kids with eye infections to an ophthalmologist.