• Unnecessary and Harmful Prescribing Practices: Antibiotics for Acute Conjunctivitis

    Written By: Lynda Seminara and selected by Stephen D. McLeod, MD

    Journal Highlights

    Ophthalmology, August 2017

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    Differentiating between viral, bacterial, and other causes of acute conjunctivitis may be challenging because of similar clinical presentations. However, most patients with this condition do not require antibiotics. Shekhawat et al. looked at data in a large managed care network to determine the frequency of fills for topical antibiotics among patients who were diagnosed as having acute conjunctivitis. The researchers found that nearly 60% of the study population filled an antibiotic prescription for acute conjunctivitis and that 20% of the patients were prescribed an antibiotic-corticosteroid product, even though corticosteroids are not indicated for acute conjunctivitis.

    This retrospective observational study included 340,372 patients with acute conjunctivitis who were diag­nosed between 2001 and 2014. The percentage of patients who filled at least 1 prescription for a topical antibi­otic within 14 days of initial diagnosis was calculated. Multivariable logistic regression analysis was used to deter­mine demographic, medical, and other factors associated with filling these prescriptions.

    Among the 340,372 participants, 198,462 (58.3%) filled at least 1 pre­scription for a topical antibiotic; 38,774 of these were for antibiotic-corticosteroid medications. Black and Latino patients were less likely to have an antibiotic prescription filled than were white patients, and more affluent and educated patients were more likely than their less-affluent and less-educated counterparts to have an antibiotic prescription filled.

    The odds of a filled antibiotic pre­scription were lower if the diagnosis was made by an ophthalmologist as opposed to another provider. Fill rates did not differ between persons at risk for serious infection (such as those who wore contact lenses or had HIV/AIDS) and those without such risk.

    The authors concluded that the high fill rates and frequent use of concom­itant corticosteroids are potentially harmful practices that may prolong infection duration, promote antibiotic resistance, and increase costs.

    The original article can be found here.