Antimicrobial stewardship

Pharmacists should be confident in explaining when not to supply antibiotic eye drops for 
infective conjunctivitis. Many people expect or request antibiotics, yet it is important to advise that most cases of bacterial conjunctivitis are self-limiting and typically resolve within five to seven days without treatment.

Guidelines routinely recommend reserving topical antibiotics for people with severe symptoms or where rapid resolution is clinically required. In other cases, a delayed treatment strategy may be appropriate. This involves advising patients to monitor their symptoms and to initiate antibiotic drops only if there has been no improvement after around three days. 

Evidence suggests that antibiotics shorten the duration of symptoms by only one to two days, and unnecessary use risks contributing to antimicrobial resistance. Community pharmacists are therefore well placed to model good antimicrobial stewardship by promoting self-care, setting realistic expectations, and using PGDs or independent prescribing only when clinically justified, in line with best practice in primary care.