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Most infections are viral and/or self-limiting and do not require antibiotics.
NHS England (NHSE) has published new prescribing guidance for various common conditions for which over-the-counter (OTC) items should not be routinely prescribed in primary care (quick reference guide). One of these conditions is conjunctivitis.
Treatments of conjunctivitis are cheap to buy and are readily available OTC along with advice from pharmacies. Please click here for further information, exceptions, and a patient leaflet.
Bacterial conjunctivitis is usually bilateral and is also self-limiting and will normally settle in 5-10 days, it is characterised by red eye with mucopurulent, not watery, discharge. Therefore, avoidance of drug treatment is an option if a patient wishes, for example during pregnancy.
They should be treated as "sticky eye(s)" with supportive therapy e.g. regular eye cleaning with cooled boiled water. Patients should be aware of the red flag symptoms and be advised to seek medical advice if they emerge.
Red flag symptoms: moderate to severe eye pain or photophobia, marked redness in one eye, reduced visual acuity or purulent conjunctivitis in a new-born infant
If child under 3 months of age: send specific chlamydial PCR swab in addition to conventional bacterial swab before application of an antibiotic
Fusidic acid has less Gram-negative activity.
Please see section 11.3 anti-infective eye preparations