Based on our own experiences as well as
recommendations of the American Academy of Ophthalmology you should be aware that
non eyecare practitioners tend to overprescribe antibiotics for a common eye
infection that typically clears up without medication. A recent study suggests
that most people with acute conjunctivitis, or pink eye, are getting
the wrong treatment. About 60 percent of patients are prescribed antibiotic
eyedrops, even though antibiotics are rarely necessary to treat this
common eye infection.
About
the Pink Eye Conjunctivitis Study
Researchers at the University of Michigan
Kellogg Eye Center looked at data from a large managed care network in the
United States. They identified the number of patients who filled
antibiotic eyedrop prescriptions for acute conjunctivitis. Then
they evaluated the characteristics of patients who filled a prescription
compared with those who did not. Of approximately 300,000 patients diagnosed
with acute conjunctivitis over a 14-year period, 58 percent filled a
prescription for antibiotic eye drops. Among them, 20 percent filled a
prescription for an antibiotic-steroid combination. Antibiotic-steroid drops
are inappropriate for most patients with acute conjunctivitis because it
may prolong or exacerbate certain types of viral infection.
Even
more troubling, the authors found that the odds of filling a prescription
depended more on a patient’s socioeconomic status than the patient's risk
for developing a more serious eye infection. For example, patients who wear
contact lenses and those diagnosed with HIV/AIDS.
Pink
eye affects 6 million people in the United States each year. There are three
types: viral, bacterial, and allergic conjunctivitis. Antibiotics are rarely
necessary to treat acute conjunctivitis. Most cases are caused by viral
infections or allergies and do not respond to antibiotics. Antibiotics are
often unnecessary for bacterial conjunctivitis because most cases are
mild and would resolve on their own within 7 to 14 days without treatment.
The
study also found:
- Primary
care providers (family physicians, pediatricians, internal medicine
physicians, and urgent care providers) diagnose a majority (83%)
of patients. Only a minority were diagnosed by eye care providers
such as ophthalmologists or optometrists.
- Patients
diagnosed by a primary care or urgent care provider were two to three
times more likely to fill prescriptions for antibiotic eye drops than
patients diagnosed by an ophthalmologist.
- Patients
who filled antibiotic prescriptions were significantly more likely to be
white, younger, better educated, and more affluent than patients who did
not fill prescriptions.
The
authors say there are several reasons why antibiotics are over prescribed.
It is a challenge to differentiate bacterial conjunctivitis from the viral
and allergic forms. All three types may have overlapping features, such as a
red eye, thin discharge, irritation, and sensitivity to light. Health care
providers may tend to “err on the side of caution” and prescribe antibiotics
“just in case.” Patients are often
unaware of the harmful effects of antibiotics and may falsely believe that
antibiotics are necessary for the infection to resolve.
If
you or someone you know develops “pink eye” conjunctivitis please call Alabama
Eye & Cataract Center in Birmingham at 205-930-0930,
visit Alabama Eye &
Cataract Center,
Google+ or www.facebook.com/alabamaeyeandcataractcenter.
