Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
LetterLetters

Treatment of conjunctivitis

David M. Maxwell
Canadian Family Physician January 2010, 56 (1) 18;
David M. Maxwell
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • eLetters
  • Info & Metrics
  • PDF
Loading

Visscher et al subtitle their excellent paper “Breaking the cycle of antibiotic prescribing.”1 They nevertheless acknowledge that physicians’ behaviour is only minimally altered by guidelines and cite several influential external factors affecting antibiotic prescribing, such as parental expectations, school board policies, and lack of patient education materials. I fear that they are too kind. Repeated studies have documented antibiotics being prescribed to patients diagnosed with common colds in the range of 40% to 50% of cases.2–4 This behaviour is not the result of lack of education or inappropriate expectations; both the physician and patient know perfectly well that antibiotics are futile. Given that this behaviour is neither rational nor apparently modifiable, I would suggest that a more useful approach is to adopt a “harm reduction” strategy.

The main problems with the inappropriate prescription of topical antibiotics, as noted by Visscher et al, are the development of resistant organisms, possible adverse reactions, and excessive costs. The first can be avoided by using antibiotics that are not used in other settings; the second can be surmounted by judicious selection of antibiotics with a very low rate of sensitization. All 3 criteria can be met by the use of over-the-counter preparations, such as polymyxin-bacitracin (eg, Polysporin). (Neomycin-containing preparations, such as Neosporin, are less desirable, as the neomycin component is quite sensitizing.) Several years ago, when I worked in a hospital that served as the regional eye-care referral centre, I undertook a study (which I never reported) of the culture results obtained over a 3-month period from all eye swabs, from both the emergency department and the ophthalmology clinic. With the notable exception of the genus Pseudomonas (which is readily identifiable clinically by the characteristic bright green pus), all organisms cultured were uniformly sensitive to polymyxin-bacitracin. I would suggest that weaning physicians off prescription antibiotic preparations by reassuring them that they can effectively kill any bacteria they might encounter with simple over-the-counter preparations—even if this goal is inappropriate—is likely to be more successful than trying to modify their imperative to prescribe.

Footnotes

  • Competing interests

    Dr Maxwell has no connection with the makers of Polysporin and no conflicts of interest to declare.

  • Copyright© the College of Family Physicians of Canada

References

  1. 1.↵
    VisscherKLHutnikCMThomasMEvidence-based treatment of acute infective conjunctivitis. Breaking the cycle of antibiotic prescribingCan Fam Physician20095510715
    OpenUrlAbstract/FREE Full Text
  2. 2.
    FischerTFischerSKochenMMHummers-PradierEInfluence of patient symptoms and physical findings on general practitioners’ treatment of respiratory tract infections: a direct observation studyBMC Fam Pract2005616
    OpenUrlCrossRefPubMed
  3. 3.
    LeblebiciogluHCanbazSPeksenYGunaydinMPhysicians’ antibiotic prescribing habits for upper respiratory tract infections in TurkeyJ Chemother20021421814
    OpenUrlPubMed
  4. 4.
    CantrellRYoungAFMartinBCAntibiotic prescribing in ambulatory care settings for adults with colds, upper respiratory tract infections, and bronchitisClin Ther200224117082
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

Canadian Family Physician: 56 (1)
Canadian Family Physician
Vol. 56, Issue 1
1 Jan 2010
  • Table of Contents
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Treatment of conjunctivitis
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Treatment of conjunctivitis
David M. Maxwell
Canadian Family Physician Jan 2010, 56 (1) 18;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Respond to this article
Share
Treatment of conjunctivitis
David M. Maxwell
Canadian Family Physician Jan 2010, 56 (1) 18;
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Footnotes
    • References
  • Info & Metrics
  • eLetters
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • We are humans first
  • Truth about grief
  • Today’s residents are ready to lead
Show more Letters

Similar Articles

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • RSS Feeds

Copyright © 2023 by The College of Family Physicians of Canada

Powered by HighWire