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Conjunctivitis - infective - Management
How do I manage the cause of persistent infective conjunctivitis?

For people with:

  • Blepharitis associated with chronic conjunctivitis, see the CKS topic on Blepharitis.
  • A positive bacterial culture, prescribe a topical ocular antibiotic directed by sensitivity results if they are still symptomatic.
  • A positive chlamydial culture, refer for testing of sexual contacts and systemic treatment.
  • A negative bacterial and chlamydial culture, consider repeating the test if symptoms persist for longer than 3 weeks.
Basis for recommendation

Basis for recommending treatment of microbiologically-proven bacterial infective conjunctivitis:

  • Evidence from good quality trials has shown that treating people with proven bacterial conjunctivitis with a topical ocular antibiotic modestly reduces the severity and duration of conjunctivitis [Sheikh and Hurwitz, 2001].

Basis for repeating swabs if initial swab is negative but symptoms persist for longer than 3 weeks:

  • A negative swab result in a person with conjunctivitis of less than 3 weeks' duration occurs most commonly when there is a viral cause for the conjunctivitis.
  • Infective conjunctivitis lasting longer than 3 weeks is unlikely to be due to viral infection but may be due to a false negative result for a chronic bacterial or chlamydial infection.

[Yanoff and Duker, 2004]

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