The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
Bacterial conjunctivitis is an infection of the conjunctiva characterised by acute onset of redness, discomfort, discharge in one or both eyes. It occurs more frequently in children and the elderly. The condition often resolves in five-seven days without treatment, but is contagious and care is needed to avoid the infection spreading to family members. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating bacterial conjunctivitis. It provides recommendation for non-pharmacological management, treatment with antibiotics and outlines when urgent referral is required.
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What is bacterial conjunctivitis?
Acute bacterial conjunctivitis is an infection of the eye in which one or both eyes become red, watery and sticky, often with discomfort but not pain. The condition is not normally serious and in most cases clears up in a few days. However, it is contagious and care needs to be taken to avoid spread of the infection amongst family members (e.g. not sharing towels etc.).
How is bacterial conjunctivitis managed?
People with acute conjunctivitis may be given antibiotics, usually in the form of eye drops or ointment, to speed recovery. However, the benefits of antibiotics for the treatment of acute bacterial conjunctivitis have been questioned. Evidence from clinical trials in GP practices suggests that antibiotic drops may not be very helpful, since these patients tend to have a less severe form of conjunctivitis than patients who are referred to a hospital eye clinic.
Conjunctivitis (bacterial) - 28 January 2025 The aetiology section has been amended to include gonococcal infection as a possible cause of bacterial conjunctivitis and as an important differential due to ITS sight threatening potential. The predisposing factors and symptoms sections provides additional information on transmission routes and typical clinical presentation for gonococcal conjunctivitis respectively. The pharmacological management section has been restructured to provide clarity on the range of topical antibiotics typically used to treat bacterial conjunctivitis. The management category section includes a new recommendation of same day referral for cases of suspected gonococcal conjunctivitis.
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