The Real Reason Doctors Are Treating Pink Eye Wrong—and What You Should Do If You Have It

puhhha/ShutterstockIt’s pretty clear when you see the those classic pink eye symptoms that you’ll be needing some drops to treat this very contagious infection, of which there are some three million cases a year, according to the Mayo Clinic.

But what if the antibiotics your doctor prescribed for pink eye (acute conjunctivitis) are actually doing more harm than good? A new study by researchers at the University of Michigan Kellogg Eye Center, published in the American Academy of Ophthalmology, is the first to evaluate antibiotic use for pink eye—and the results may surprise you.

Though antibiotics are the go-to treatment for bacterial infections, most cases of pink eye are caused by viral infections or allergies—and antibiotics won’t help them, the study authors say. And even mild bacterial cases of pink eye could resolve within seven to 14 days without antibiotics.

So not only will the antibiotics not help clear the pink eye, but overprescribing antibiotics increases cost for consumers, raises our resistance to the antibiotic, and contributes to the rise of dangerous superbugs. In a way, it’s like the boy who cried wolf. Each time you “cry” for antibiotics when your body doesn’t really need them, the antibiotics grows weaker. (Here are times you need an antibiotic—and times you don’t.) And it seems that both patients and doctors are to blame.

“This study opens the lid on overprescribing of antibiotics for a common eye infection,” said lead author Nakul S. Shekhawat, MD, MPH. “It shows that current treatment decisions are not based on evidence, but are often driven more by the type of health care practitioner making the diagnosis and the patient’s socioeconomic status than by medical reasons. The potential negative consequences are difficult to justify as we move toward focusing on value in health care.”

By reviewing data from a large managed care network in the U.S., the researchers identified patients who filled antibiotic eye drop prescriptions for acute conjunctivitis. Then they compared the characteristics of those who filled the prescription vs. those who didn’t.

Out of 300,000 patients over a 14-year period, 58 percent filled a prescription for antibiotic eye drops, with 20 percent receiving an antibiotic-steroid combo. And that’s perhaps worse than antibiotics alone because antibiotic-steroid combo drops can prolong or exacerbate certain types of viral infections including pink eye, per the study authors.

So if antibiotics are a no-go for viral and allergic eye infections, why are health care providers prescribing them? According to the study authors, it can be challenging to differentiate the symptoms of bacterial conjunctivitis from viral and allergic forms. Red eye, thin discharge, irritation, and sensitivity to light can be present in all cases, so providers tend to “err on the side of caution” and prescribe antibiotics “just in case.” Also, patients falsely believe that antibiotics are needed for pink eye treatment.

What can you do? Be your own advocate when it comes to medical diagnosis and treatment. Be aware that the American Academy of Ophthalmology has recommended that health care providers avoid prescribing antibiotics for viral conditions and to delay immediate treatment when the exact nature of the eye infection is unknown.

These are the essential questions to ask your doctor before taking antibiotics—for pink eye or any other infection.