Antibiotic prescription for infective conjunctivitis in general practice

Infective conjunctivitis is a common self-limiting condition which constitutes around 35% of ocular presentation in general practice. A Cochrane systematic review investigating the effect of antibiotic treatment in the management of bacterial conjunctivitis concluded that the benefits from antibiotic use compared to placebo were marginal. UK National clinical guidelines further state that topical antibiotics should not be prescribed as first line treatment for conjunctivitis. The aim of this audit was to compare the frequency of antibiotic prescription at a busy general practice surgery against the standard set by national guidelines.  A retrospective analysis of patients presenting with symptoms and signs of infective conjunctivitis over a period of fifteen months were collated using the System One patient database. Ninety-seven percent of patients included in the study were prescribed topical antibiotics as first line treatment for conjunctivitis. Another 2% of consultations showing evidence of delayed prescribing. Doctor and patient education is important to manage expectations relating to the prescription of antibiotic to reduce unnecessary use. This has implications for reducing antibiotic resistance and improving cost-effectiveness of treatment. Changes implemented at the practice following the audit included updating general practitioners on the latest evidence and national guidelines on infective conjunctivitis management and creating an information leaflet for patients presenting with infective conjunctivitis containing advice on supportive measures to manage their symptoms.

Author(s): Chandni Nigam

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