Doing Nothing

(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.